Interference in Pulse Oximetry in a Neonate with Bronze Baby Syndrome

Reliable estimation of pulse oximetry (SpO₂) is indispensable in a neonatal intensive care setting. Along with clinical examination, SpO₂ is a validated non-invasive correlate of PaO₂ to dictate the level of respiratory support. Any alterations that may interfere with this correlation pose significant challenges and lead to inadvertent over- or under-treatment. The authors report a case with an unusual discrepancy between SpO₂ and PaO₂ in a neonate with jaundice who developed bronze baby syndrome while receiving phototherapy. A review of similar previous reports suggests that abnormal pigment accumulation in bronze baby syndrome may render pulse oximetry transiently unreliable.