Inconsistent Pulse Oximetry Signal in Multiple Sites as an Early Indicator of Severe Hypovolemia

A low-quality pulse oximetry signal should not be overlooked, as this may indicate cases of severe hypovolemia. Although this sign is not specific for volume depletion, it can provide a quick, non-invasive indication about possible hypovolemia if a proper signal cannot be obtained, especially when difficulties are encountered in obtaining SpO₂ readings from multiple sites. Severe hypovolemia is a preventable risk factor for shock and other electrolyte abnormalities, which, if untreated, may lead to cardiovascular collapse or even necessitate cardiopulmonary resuscitation (CPR). This case report highlights the potential usefulness of a pulse oximeter's poor signal in multiple sites in helping providers detect volume depletion in the perioperative setting, which could prevent avoidable causes of acute decompensation during anesthetic induction.