Does bilirubin impact pulse oximeter accuracy?

Elevated bilirubin has been reported by some studies to potentially underestimate oxygen saturation by pulse oximetry, though most available data have not shown any effect on the accuracy of Spo2 with bilirubin levels up to 84.3 mg/dlitre. The light absorption spectrum of bilirubin has a broad peak at 460 nm and two smaller peaks at 560 nm and 600 nm.  Based on this, bilirubin is relatively unlikely to have a detectable effect on the absorption of the 660 nm and 940 nm wavelengths commonly used by pulse oximeters.

References:

https://pubmed.ncbi.nlm.nih.gov/2024749/

https://pubs.asahq.org/anesthesiology/article/70/1/118/30895/Hyperbilirubinemia-Does-Not-Interfere-with

https://pubmed.ncbi.nlm.nih.gov/2967958/