Poor oximeter performance (i.e. either inaccurate or absence of a reading) during low perfusion is a known phenomenon in clinical and laboratory settings. If a patient is cold or has peripheral vasoconstriction and poor perfusion, the pulse oximeter may have difficulty detecting a good pulse signal on the fingertip. This affects some oximeters more than others. Some oximeters perform wandering readings while others may produce steady but inaccurate results. At present, there is no requirement by certifying bodies to test oximeter accuracy under controlled or standardized conditions of low perfusion. Nonetheless, some manufacturers and labs do this testing routinely. The OpenOximetry.org Project is working to publish these data in our database while developing and advocating for standards for performance during low perfusion.
References: Lifebox Pulse Oximetry Learning Module
Keywords: vasoconstriction, poor perfusion, cold