The literature concerning the effect of bilirubin on oximetry can appear confused. Two authors 1,2 state that bilirubin can affect pulse oximetry readings, but neither give any evidence or references to support this. Moyle in the authoritative 'Pulse Oximetry'3 reviews the subject and concludes that pulse oximetry is accurate, but that cooximetry - the usual 'gold standard' method of verifying pulse oximeter readings - is not.
This last point is supported by two case studies 4 , the authors of which feel "... in the presence of severe hyperbilirubinemia, pulse oximetry may be more accurate than co-oximetry".
Abrams et al 5 looked at pulse oximetry in patients with liver disease. They found that pulse oximetry overestimated oxygen saturation as measured by a co-oximeter in both their subjects and their controls.
Veyckmans et al 6 carried out research on the influence of bilirubin on pulse oximetry and concluded "There was thus no demonstrable direct influence of high bilirubin plasma levels on SpO2 as measured by a Nellcor (r) pulse oximeter".
page last modified: 04/09/2005