Respiratory Physiology

GAS
TRANSPORT-II

DR. MOHD SALEH AHMAD KAMAL

Learning Outcomes:

• Discuss diffusion of O2 and CO2

• Describe modes of gaseous transport
• List different types of tissue hypoxia
• Draw and explain Oxyhaemoglobin dissociation
curve
…RESPIRATORY GAS DIFFUSION…

• The net movement - gas molecules - from area the

particular gas exerts a higher partial p. to area the
gas exerts a lower partial p.
• Different gases move according to their individual
pressure gradients.
• Major mechanism of gas movements :-
1) alveoli  blood  tissue
2) tissue  blood  alveoli
O2 and CO2 Partial Pressures
O2 and CO2 Partial Pressures
O2 and CO2 Movement
…TRANSPORT OF GASES…
OXYGEN (O2) CARBON DIOXIDE (CO2)
1) Dissolved in plasma 1) Physically dissolved in
(1.5%) PaO2 plasma (5%)
2) Bicarbonate Form (85%)
CO2 + water
2) Bound to Hb (98.5%)  carbonic acid (H2CO3)
 oxyhaemoglobin   bicarbonate ions
O2 saturation (HCO3ˉ)– (advantage in RBC
due to have carbonic
anhydrase enzyme)
3) CarbaminoHb (10%)
Chemically bound to globin in
RBC  (= carbamic acid/
carbaminoprotein)
1

Carbon dioxide
(CO2)

2
Oxygen (02)
1
DIFFUSION OF O2 FROM PERIPHERAL
CAPILLARIES INTO THE TISSUE FLUID

Rapid diffusion of O2 from blood into tissues due to tremendous

initial pressure difference
 CARBON DIOXIDE (CO2) TRANSPORT

• CO2 (product of tissue metabolism)  transported

from the tissues to the lungs  unloaded  to be
removed to the atmosphere.
• Solubility of CO2 in blood is about 20x that of O2
• Under normal resting conditions, an average of 4ml of
CO2 are transported from the tissues to the lungs in
each 100ml of blood
• pH of blood drops from 7.4 to 7.36 (acidic)
 CO2 INVOLVES IN ACID-BASE BALANCE
1

CARBONIC ACID BUFFER
OXYHAEMOGLOBIN
DISSOCIATION
CURVE
 MECHANISM OF OXYGENATION

• Oxygenation = the process of oxygen to combine with

haemoglobin (Hb) to form a loose & reversible
combination and converts deoxyHb into oxyHb.
• Oxygen transported in blood in 2 forms :
1) combination with haemoglobin (Hb) – 98%
2) dissolved form (in plasma) – only 2%
• Oxygen can be measured in three forms:
1) partial pressure of oxygen (PaO2) – by
arterial blood gas (ABG)
2) oxygen saturation (SaO2) = % Hb saturation
– by ABG
3) calculated estimate of oxygen saturation
(SpO2): an indirect SaO2 – by pulse oximetry
 HAEMOGLOBIN STRUCTURE
• Hb concentration is an index of O2 carrying
capacity of blood.
• Hb consists of :
- protein globin  2 α chains & 2 β chains
- haem (iron – porphyrin complex)
• 1 Hb  4 globins  each haem attach to
each globin  each iron (Fe++) attach to each
haem
• 1 molecule of O2 combine with 1 iron ion of
haem molecule
• 1 molecule Hb has 4 haem molecule  1
molecule Hb can carry 4 O2 molecules
OXYGEN-HEMOGLOBIN DISSOCIATION
CURVE
 S shape :  O2 combines
with Hb very rapidly

 (flat/plateau phase)

 (steep slope phase)

P50 is the PO2 at which the

Hb is half saturated ; the
higher the P50 the lower the
affinity (PO2 of 26.6 mmHg
with SaO2 of 50%)
 OXYHAEMOGLOBIN – DISSOCIATION
CURVE
• Indicates the relationship between the oxygen saturation of hemoglobin
(SaO2) & the partial pressure of arterial oxygen (PaO2).
• PaO2 ranges from 80 to 100 mm Hg.
• Normal SaO2 measures about 97% but may range from 93% to 97%.
• Graphically represents the affinity between oxygen and hemoglobin—
specifically, how the oxygen saturation of hemoglobin (SaO2) relates to the
partial pressure of arterial oxygen (PaO2).
• Transport of sufficient oxygen to the tissues depends on :
1) adequate number of hemoglobin molecules
2) sufficient blood volume and circulation (cardiac output & blood pressure).
• Once hemoglobin transports oxygen to the tissues, the body’s environment
determines how much of the oxygen dissociates (unloads) from hemoglobin
for use.
• Oxygen dissociation from hemoglobin is determined by tissue demand for
oxygen.
 PHYSIOLOGICAL SIGNIFICANCE OF S-SHAPE
(ADULT Hb)

a) Flat upper part

• Means : oxygen easily bind to Hb
•  PaO2 can drop to about 80 mmHg & yet
Hb will still remain highly saturated (96%)
with O2
•  keeps the arterial oxygen concentration
high despite impairment in O2 in the lung.
• A significant PaO2 change in this relatively
flat part of the curve produces only a small
change in SaO2.
• Thus, a patient’s oxygenation status is better
protected at this flat portion.
• Hb can’t be saturated more than 100%, but
PaO2 can rise significantly above 100 mm Hg
if the patient receives high O2
concentrations
 b) Steep lower part

• The steep lower part means that if the

tissues require more O2, substantial
amounts of O2 can be removed from Hb
the pressure gradient for diffusion of O2
from capillary to cell tends to be relatively
well maintained despite the much
increased O2 extraction.
PaO2 measures between 40 and 60
mm Hg  oxygen is released from Hb to
the capillaries at the tissue level due to
increased O2 demand.
• Advantages- large O2 unloading and
maintained O2 diffusion gradient
CO2
FACTORS AFFECTING THE CURVE

Right side = decrease Hb affinity of O2 

Release oxygen (to tissues)  BOHR EFFECT
 WHAT “SHIFT” MEANS???

• Increased P50 = a rightward shift of the standard curve =

a larger partial pressure is necessary to maintain a 50%
oxygen saturation = decreased Hb affinity.
• A rightward shift causes a decrease in the affinity of Hb
for O2  easier to release
• Leftward shift  increases the affinity  harder to
release.
 In Increased CO2( Right Shift of Curve)
(Increased acidity has the same effect)

lowering Hb's affinity for O2 via

the BOHR EFFECT.
• Easily released of O2 from Hb
unbound Hb molecules have a
greater chance for CO2 to bind
with Hb
carbaminohaemoglobin
 …TISSUE HYPOXIA…(Condition of having
insufficient O2 at the cell level)
TYPE OF HYPOXIA CAUSES PaO2 CaO2 O2 O2
DELIVERED UTILIZED

1) HYPOXIC decrease PaO2 LOW Normal LOW Normal

& V/Q ratio

2) CIRCULATORY 1) Vascular ds Normal Normal LOW Normal

(STAGNATE) 2) Arterial –
venous
shunt

3) ANEMIC 1) CO Normal LOW Normal Normal

poisoning
2) Anaemia

4) HISTOTOXIC Cyanide Normal Normal Normal LOW

poisoning
 THE CO DISSOCIATION CURVE
2

• The amount of CO2 in the blood

depends upon the partial pressure
of CO2(PaCO2)
• The relationship between the CO2
content and PaCO2 is the CO2
dissociation curve
• The normal CO2 dissociation curve
shows that :
- the CO2 content in the blood is
48ml% when PCO2 is 40 mmHg.
- it is 52ml% when the PCO2 is 48
mmHg
- It is 70ml% when PCO2 is 100
mmHg
 OXY-HB DISSOCIATION CURVE IN
CARBON MONOXIDE (CO) POISING

• CO + Hb COHb
• Reduce the affinity of Hb to O2
(250X binding capacity
compare with O2)  lethal
• Shifts Hb dissociation curve to
the left
• Hypoxia due to CO poisoning
does not stimulate respiration
as PaO2 is the same
 MYOGLOBIN

• A pigment in skeletal muscle

• Has a similar structure with
one of the subunit of Hb
• Each myoglobin only
combines with 1 molecule of
O2
• The dissociation curve –
hyperbola
• A higher affinity to O2
• Releases O2 when PO2 is really
low
Respiratory Terms
•THANK YOU