Absorption spectra of human fetal and adult oxyhemoglobin, de-oxyhemoglobin, carboxyhemoglobin, and methemoglobin.

We determined the millimolar absorptivities of the four clinically relevant derivatives of fetal and adult human hemoglobin in the visible and near-infrared spectral range (450-1000 nm). As expected, spectral absorption curves of similar shape were found, but the small differences between fetal and adult hemoglobin absorptivity were important enough that they should be taken into account in multicomponent analysis of hemoglobin derivatives. Common pulse oximeters, however, involving light of 660 and 940 nm, are so insensitive to the presence of fetal hemoglobin that they can be used safely in neonates. The error in pulse oximetry caused by the presence of carboxyhemoglobin is insubstantial, but methemoglobin gives either an understimation or an overestimation at high or low oxygen saturation, respectively, the turning point being near 70% saturation.