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The measurement of dyshemoglobins and total hemoglobin by pulse oximetry

Barker, Steven J; Badal, John J

Current Opinion in Anaesthesiology: December 2008 - Volume 21 - Issue 6 - p 805–810
doi: 10.1097/ACO.0b013e328316bb6f
Technology, education and training: Edited by Kirk Shelley

Purpose of review Recent advances in pulse oximetry have made it possible to noninvasively measure total hemoglobin, as well as the two most common dyshemoglobins. This review will trace the development and clinical application of multiwavelength pulse oximetry.

Recent findings Until now, commercially produced pulse oximeters have utilized two wavelengths of light and could measure only the ratio of oxyhemoglobin to total hemoglobin, displayed as SpO2. Pulse oximeters using up to 12 light wavelengths have recently been developed by Masimo Corp. (Irvine, California, USA). These new ‘Rainbow Pulse CO-oximeter’ instruments can estimate blood levels of carboxyhemoglobin, methemoglobin, and total hemoglobin (SpHb), as well as the conventional SpO2 value. The accuracy of these new measurements has been studied in human volunteers and clinical trials. Some interesting case reports have documented the use of this new technology in diagnosis and treatment.

Summary The development of multiwavelength pulse oximeters, which can measure total hemoglobin as well as dyshemoglobins, should result in improved patient care.

Department of Anesthesiology, The University of Arizona College of Medicine, Tucson, Arizona, USA

Correspondence to Steven J. Barker, PhD, MD, Department of Anesthesiology, University of Arizona College of Medicine, P.O. Box 245114, Tucson, AZ 85724-5114, USA Tel: +1 520 626 7195; fax: +1 520 626 6066; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.