Gas Transport PDF

Transport of gases
by the blood
Dra. Ma. Elena Torres Zazueta

mzazueta@uag.mx
Universidad Autónoma de Guadalajara, A.C. © , 2014,
2013 2015
General Objectives
• Define: percent hemoglobin saturation, oxygen tension, oxygen
content as they pertain to blood and be able to make calculations.
• Explain the exchange of oxygen between the alveolar air and
pulmonary capillary blood, and between the systemic capillary blood
and the tissues
• Discuss the transport of O2 by the blood
• Interpret the O2-Hb dissociation curve and explain the relationships
between oxygen partial pressure, hemoglobin saturation, and blood
oxygen content.
• Discuss factors that affect O2-Hb dissociation curve.

2013 2015
Terminology related to Oxygen transport
• Oxygen partial pressure

• Oxygen capacity vol%
• Oxygen saturation of Hb
• Oxygen content
• P50

2013 2015
Oxygen transport
• Dissolved O2
– Is proportional to the partial pressure
• In combination with hemoglobin

2013 2015
Universidad Autónoma de Guadalajara, A.C. © , 2013
Oxygen Transport in Dissolved Form
• The amount of O2 in dissolved form obeys Henry’s

law
CO2 = O2 PO2
O2 = solubility coefficient of O2 in blood.
O2 = 0.003 ml O2/100 ml blood/mmHg.
• Normal arterial blood with PO2 of 100 mmHg

contains ONLY 0.3 ml O2/100 ml of blood.
Universidad
UniversidadAutónoma
Autónomade
deGuadalajara,
Guadalajara,A.C.
A.C.©©,,2013
2014,
2015
Oxygen transport
• Oxygen carrying capacity
– Maximum amount of O2 that can be combined
with Hb
• 1gm of pure Hb combine with 1.39 ml O2
• Hb is not 100% pure then:
1 gm of Hb combine with about 1.34 ml O2
15 gm of Hb x 1.34 ml O2 = 20.1 ml O2/ml of blood

Universidad Autónoma de Guadalajara, A.C. © , 2014, 2015
Transport of oxygen
• Oxygen saturation
– Percentaje of Hb binding sites that have O2 attached
O2 combined with Hb X 100

O2 capacity
Arterial blood PO2 = 100 = Sat 97.5%

Venous mixed blood PO2 = 40 = Sat 75%
Universidad Autónoma
Universidad Autónoma de
de Guadalajara,
Guadalajara, A.C.
A.C. ©
© ,, 2014,
2013 2015
Arterial and Venous O2 Content
Attached to Hb dissolved

2013 2015
Objectives
• Draw and label an oxyhemoglobin dissociation curve
(hemoglobin oxygen equilibrium curve), showing the
amount of dissolved oxygen and the relationships
between oxygen partial pressure, hemoglobin
saturation, and blood oxygen content.
• How does the shape of the oxyhemoglobin
dissociation curve influence the uptake and delivery
of oxygen?
• Define P50.
• Show how the oxyhemoglobin dissociation curve is
affected by changes in blood temperature, pH,
PCO2, and 2,3-DPG.
2013 2015
Oxygen dissociation curve

Oxygen dissociation curve
P50
PO2 when
50% of
Hemoglobin
is saturated

O2-Hb
Dissociation
curve Shift to
the right
• Increase in
temperature
• Increase in CO2
• Decrease in pH
• Increase in 2,3-DPG

Factors Influencing Hemoglobin Saturation
Increased temperature and 2,3-

DPG reduces O2 affinity.
Hydrogen Ion:
Increased H+ (↓ pH)
↑ H+ binding to Hb and
↓ O2 affinity
(HbO2+ H+  HbH+ +O2).
Carbon Dioxide (Bohr’s effect):

Increased PCO2,
↑ CO2 binding to Hb and
↓ O2 affinity (↑ O2 delivery to
tissue).

• Sigmoidal curve because of Cooperativity among
the 4 O2 binding sites.
• At low PO2, low affinity, small increase in binding
• At moderate PO2 values, increased PO2 , the
amount of bound O2 increases more steeply with
increases in PO2. So the affinity increases.
• At high PO2 the curve flattens as Hb saturates
2013 2015
Objectives
• List the forms in which carbon dioxide is carried
in the blood. Identify the percentage of total
CO2 transported as each form.
• Describe the importance of the chloride shift in
the transport of CO2 by the blood.
• Identify the enzyme that is essential to normal
carbon dioxide transport by the blood.
• Draw the carbon dioxide dissociation curves for
oxy and deoxyhemoglobin. Define the interplay
between CO2 and O2 binding on hemoglobin
that causes the Haldane effect.

Carbon Dioxide Transport
• Physically dissolved
0.0006 ml CO2/mmHg PCO2 / 1 ml plasma = 2.4 ml CO2
• CO2 as Bicarbonate Ions (HCO3-):

Amount of CO2 stored as HCO3- at PCO2= 40 mmHg is about
42 ml/dl (90 % of the total arterial CO2).
80-90% is carried as bicarbonate ions
• Protein-bound CO2 (carbomino compunds):

R–NH2 + CO2  R–NH–COO– + H+.
Amount of CO2 stored as carbamino compounds is
about 2.1 ml/dl (4% of the total arterial CO2).
CO2 dissociation curve
As the % of HbO2
saturation
decreases, the
CO2 concentration
for a given PCO2
increases

Transport and Exchange of CO2
• At the tissues:
– Bicarbonate quickly diffuses from RBCs into the plasma
– Chloride shift – to counterbalance the outrush of
negative bicarbonate ions from the RBCs, chloride ions
(Cl–) move from the plasma into the erythrocytes
Transport and Exchange of Carbon Dioxide
Tissue level

2013 2015
Transport and Exchange of Carbon Dioxide
Lung level

2013 2015
Haldane and Bohr Effect
• The amount of carbon dioxide transported is
markedly affected by the Po2
• Haldane effect – At lung level, binding of O2 with

the hemoglobin displace CO2 from the blood.
• Bohr effect - At the tissues, as more carbon

dioxide enters the blood:
– More oxygen dissociates from hemoglobin
– More carbon dioxide combines with hemoglobin, and
more bicarbonate ions are formed

Physiological and clinical
importance of PaCO2
• Must be measured to asses ventilation

• Abnormal levels are clear danger signal
• Never wait for cyanosis to correct ventilation
• PaCO2 Influences ventilation, oxygenation
and acid-base status
• Sedatives alter the CO2 response curves
(PCO2 causes less stimulation of ventilation)

2013 2015
Objectives
• Mechanisms of hypoxia
• Describe how anemia and carbon
monoxide poisoning affect the shape of
the oxyhemoglobin dissociation curve,
Pao2, Pco2, and Sao2.

2013 2015
Mechanism of hypoxia
1.Hypoxic
– E.g. high altitude
– Carotid bodies are stimulated by the low PO2, and
ventilation increases, then the PCO2 is below normal
2. Anemic
– True anemia: low oxygenation due to low hemoglobin
– Relative anemia: low oxygenation due to CO intoxication
3.Stagnant (hypoperfusion hypoxia)
– e.g. chronic heart failure
– Increased difference in the a-v content
4.Histotoxic
– Cyanide poisoning (CN) metabolic inhibitor that blocks
oxidative phosphorilation
1. Hypoxic hipoxia
– E.g. high altitude
– Carotid bodies are stimulated by the low PO2,
and ventilation increases, then the PCO2 is
below normal
VCO2
PACO2 =
VA
PB= 447
PaCO2= 30
PAO2 = 447- 47 x 0.21 – 30 = 46.5

0.8
2013 2015
2. Anemic hipoxia
– True anemia: low oxygenation due to low
hemoglobin
PAO2 = 760- 47 x 0.21 – 40 = 100

0.8
CaO2 = 10 x 1.39 x .97 + 0.003 x 100 = 13.78

2013 2015
2. Anemic hypoxia
– Relative anemia:
Low oxygenation due to CO intoxication
PAO2 = 760- 47 x 0.21 – 40 = 100

0.8
CaO2 = 15 x 1.39 x .60 + 0.003 x 100 = 12.81

Anemia CO
O2 Capacity Hb concentration x 1.34
O2 combined with
SaO2 Hb O2 capacity X 100
CaO2 O2 capacity x SaO2% +αO2xPaO2
PaO2 PB - PvH2O x FO2 – PCO2

R

3. Stagnant (hypoperfusion hypoxia)
– e.g. chronic heart failure
– Increased difference in the a-v content
Low CO
19.5 vol% 11.0 vol %
Normal a-v O2 difference = 5 vol %

4. Histotoxic hipoxia
– Cyanide poisoning (CN) metabolic inhibitor
that blocks oxidative phosphorilation
19.5 vol% 18.0 vol %

From Pulmonary Physiology 6th E Michael Levitzky

2013 2015
Summary
 Terminology related to Oxygen transport
 Oxygen transport
 Arterial and Venous O2 Content

 Oxyhemoglobin dissociation curve
 Factors Influencing Hemoglobin Saturation
 Carbon Dioxide Transport

 CO2 dissociation curve
 Mechanism of hypoxia  Hypoxic hypoxia
 Anemic hypoxia
 Hystotoxic hypoxia
 Stagnant hypoxia

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Transport of gases

Dra. Ma. Elena Torres Zazueta

Universidad Autónoma de Guadalajara, A.C. © , 2014,

• Oxygen partial pressure

Universidad Autónoma de Guadalajara, A.C. © , 2014,

• In combination with hemoglobin

Universidad Autónoma de Guadalajara, A.C. © , 2014,

• The amount of O2 in dissolved form obeys Henry’s

• Normal arterial blood with PO2 of 100 mmHg

15 gm of Hb x 1.34 ml O2 = 20.1 ml O2/ml of blood

Universidad Autónoma de Guadalajara, A.C. © , 2013

O2 combined with Hb X 100

Arterial blood PO2 = 100 = Sat 97.5%

Universidad Autónoma de Guadalajara, A.C. © , 2014,

Universidad Autónoma de Guadalajara, A.C. © , 2013

Universidad Autónoma de Guadalajara, A.C. © , 2013

Universidad Autónoma de Guadalajara, A.C. © , 2013

Increased temperature and 2,3-

Carbon Dioxide (Bohr’s effect):

Universidad Autónoma de Guadalajara, A.C. © , 2013

Universidad Autónoma de Guadalajara, A.C. © , 2013

• CO2 as Bicarbonate Ions (HCO3-):

• Protein-bound CO2 (carbomino compunds):

Universidad Autónoma de Guadalajara, A.C. © , 2013

Universidad Autónoma de Guadalajara, A.C. © , 2014,

Universidad Autónoma de Guadalajara, A.C. © , 2014,

• Haldane effect – At lung level, binding of O2 with

• Bohr effect - At the tissues, as more carbon

Universidad Autónoma de Guadalajara, A.C. © , 2013

• Must be measured to asses ventilation

Universidad Autónoma de Guadalajara, A.C. © , 2014,

Universidad Autónoma de Guadalajara, A.C. © , 2014,

PAO2 = 447- 47 x 0.21 – 30 = 46.5

PAO2 = 760- 47 x 0.21 – 40 = 100

Universidad Autónoma de Guadalajara, A.C. © , 2014,

PAO2 = 760- 47 x 0.21 – 40 = 100

CaO2 = 15 x 1.39 x .60 + 0.003 x 100 = 12.81

Universidad Autónoma de Guadalajara, A.C. © , 2013

O2 Capacity Hb concentration x 1.34

CaO2 O2 capacity x SaO2% +αO2xPaO2

PaO2 PB - PvH2O x FO2 – PCO2

Universidad Autónoma de Guadalajara, A.C. © , 2013

19.5 vol% 11.0 vol %

Normal a-v O2 difference = 5 vol %

19.5 vol% 18.0 vol %

Universidad Autónoma de Guadalajara, A.C. © , 2013

Universidad Autónoma de Guadalajara, A.C. © , 2014,

 Arterial and Venous O2 Content

 Factors Influencing Hemoglobin Saturation

 Carbon Dioxide Transport

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