Pulse oximetry interference in bronze baby syndrome

A case of a neonate with Rhesus hemolytic disease of the newborn who went on to develop bronze baby syndrome (BBS) is reported. During his admission, inconsistencies between pulse oximetry saturations (SpO(2)) and his arterial partial pressure of oxygen (PaO(2)) measurements raised the suspicion of interference with our SpO(2) monitoring. Although bilirubin has been heavily investigated with respect to SpO(2) interference, a brown pigment has been shown to be produced in patients with BBS, which exhibits spectral absorbances that may cause interference with the pulse oximeter. This needs further exploration, but highlights the need to interpret SpO(2) readings with caution in neonates with BBS. Journal of Perinatology (2009) 29, 828-829; doi: 10.1038/jp.2009.35