GAS TRANSPORT

 THE PRIMARY FUNCTION OF

GAS EXCHANGE IS
OXYGENATION OF VENOUS
BLOOD
OXYGEN TRANSPORT

 means by which blood carries oxygen

from alveoli to metabolically active
tissues, where oxygen is used for
energy production
FORMS OF OXYGEN IN BLOOD

 Dissolved oxygen – 2%
 O2 bound to hemoglobin- 98%
• 1 gram of hemoglobin can
bind with 1.34ml of
oxygen
– Hb + O2 HbO2
– the reaction is a
function of the partial
pressure of oxygen in
the blood
– in the lungs --- reaction
is shifted to the
right
– in the tissues ---
reaction is shifted to
the left
Variants of the hemoglobin
molecule

 METHEMOGLOBIN
- iron is in the ferric state, oxidized by
nitrates or sulfonamides
- does not bind oxygen

 Normally only ~1.5% of total Hb

 Contribution of metHb reduces blood O2

binding capacity
Variants of the hemoglobin
molecule

 FETAL HEMOGLOBIN
- α2 γ2
- has a higher affinity for O2
Variants of the hemoglobin
molecule

 Hemoglobin S
- in sickle cell disease
- β subunit is abnormal
- O2 affinity of hemoglobin S is less than
the O2 affinity of hemoglobin A
O2 binding capacity

 maximum amount of oxygen that can be

bound to hemoglobin per volume of
blood
 normally 20ml O2/100 ml of blood
Oxygen content

 Amount of oxygen actually bound to

hemoglobin (whereas capacity is the
amount that can potentially be bound)
O2 delivery to tissues

 determined by blood flow and the oxygen

content of blood
 OXYGEN DELIVERY
= cardiac output X oxygen content of
blood
= cardiac output X (dissolved O2 +
oxyhemoglobin)
PERCENT SATURATION (SO2)

 = O2 content X 100
O2 capacity
 ratio of the quantity of oxygen actually bound
to the quantity that can potentially be bound
 ex: if O2 content is 16ml O2/100ml blood and
O2 carrying capacity is 20ml O2/100ml blood,
then the blood is 80% saturated
 normally, arterial blood is 97% saturated
with oxygen
 Influence of PO2 on
Hemoglobin Saturation
 98% saturated arterial blood contains 20 ml
oxygen per 100 ml blood (20 vol %)
 Amount of oxygen transported by Hb in
venous blood is about 14.4ml O2 per 100ml

 As arterial blood flows through capillaries,

5 ml oxygen are released
 Hemoglobin Saturation
Curve
 Hemoglobin is almost
completely saturated
at a PO2 of 70 mm Hg

 Further increases in
PO2 produce only
small increases in
oxygen binding
Hemoglobin Saturation
Curve

Figure 22.20
 RELATED INDICES OF
OXYGEN TRANSPORT

 1. blood PO2 – related to the amount

of dissolved O2
2. O2 saturation
3. oxygen content – a better gauge for
oxygenation
- is what keeps us alive

 relationship is illustrated by the

oxyhemoglobin equilibrium curve
OXYGEN CONTENT

 affected by amount of Hemoglobin

 a person can have a normal arterial PO2 and
a normal saturation but reduced oxygen
content
- seen in patients with anemia
 blood volume
 OXYHEMOGLOBIN
DISSOCIATION CURVE

 sigmoidal curve
(S-shaped)
 why sigmoidal?
Because the
hemoglobin affinity
for oxygen increases
progressively as
blood PO2
OXYHEMOGLOBIN

site 4 –O2 attached when the minimal pO2 = 100mmHg

site 3 –O2 attached when the minimal pO2 = 40mmHg

site 2 –O2 attached when the minimal pO2 = 26mmHg

site 1 –O2 O2 remains attached under physiologic

conditions
 OXYHEMOGLOBIN
DISSOCIATION CURVE

 plateau region
- loading phase,
where oxygen is
loaded onto Hb to
form HbO2
- describes how O2
saturation and
content remain
constant despite
fluctuations in
alveolar PO2
 OXYHEMOGLOBIN
DISSOCIATION CURVE

 steep region
- unloading phase,
allows large
quantities of O2 to
be released
(dissociated) at the
lower capillary O2
that prevails at the
tissue level without
large changes in PO2
OXYHEMOGLOBIN
DISSOCIATION CURVE

 In brief, oxygen can saturate

hemoglobin under high partial
pressures in the lung and
oxyhemoglobin can give up (dissociate)
large amounts of oxygen with small
changes in PO2 at the tissue level
 OXYHEMOGLOBIN
DISSOCIATION CURVE

 P50
- PO2 at which 50%
of the Hb is
saturated P50
- indicator of the
binding affinity of
Hb for O2 and will
determine the
relative position of
the curve
 OXYHEMOGLOBIN
DISSOCIATION CURVE

 P50
- normal P50 for
arterial blood:
26-28 mmHg P50
- high P50: decrease
affinity,
rightward shift
- low P50: increase
affinity, leftward
shift
• If
the curve is shifted to
the right, P50 increases, and
O2 unloading is facilitated

• If the curve is left-shifted,

P50 is decreased, O2
unloading is impaired
OXYHEMOGLOBIN
DISSOCIATION CURVE

 body temperature, arterial carbon

dioxide tension and arterial pH affect
the binding affinity of Hb
OXYHEMOGLOBIN
DISSOCIATION CURVE

 ↑body temperature, ↑arterial carbon

dioxide tension and ↓arterial pH →
shift the curve to the right
 physiologically advantageous at the
tissue level (steep phase) because the
affinity is lowered (increased P50)
 enhances unloading of O2
OXYHEMOGLOBIN
DISSOCIATION CURVE

 ↓ body temperature, ↓ arterial carbon

dioxide tension and ↑ arterial pH →
shift the curve to the left
 leftward shift increases the affinity of
hemoglobin for oxygen thereby
lowering the ability to release oxygen
to the tissues
 The Effect of Blood pH on the Affinity of
Hemoglobin for O2

 Increased pH of blood
(more basic) the
greater the affinity

 Decreased pH of blood
(more acidic) the lower
the affinity
The Effect of pCO2 on the Affinity of
Hemoglobin for O2

 Low pCO2 the higher

the affinity
 High pCO2 the lower
the affinity
 H2O + CO2
 Bohr Effect

H20 + CO2 Carbonic Acid (H2CO3) H+ + HCO3

 The Effect of Blood Temperature on the
Affinity of Hemoglobin for O2

 Lower the
temperature
the greater the
affinity

 Higher the
temperature the
lower the affinity
Functional importance of
these shifts:

 an exercising muscle is HOT, ACIDIC, and

has a HIGH PCO2, all of which favor
UNLOADING more oxygen to the
metabolically active cells
 OXYHEMOGLOBIN
DISSOCIATION CURVE
2,3 DPG (2,3BPG)
 an organic phosphate in RBCs
 byproduct of anaerobic metabolism
 2,3-BPG combines with hemoglobin to reduce
its affinity for O2, thus promoting delivery of O2
to the tissues.
 an increase in 2,3DPG facilitates unloading of
oxygen from the red cell at the tissue level
(shifts the curve to the right)
 ↑2,3 DPG occurs with exercise, hypoxia (e.g.
high altitudes, chronic lung disease)
2,3 DPG (2,3BPG)

 an increase in 2,3DPG facilitates

unloading of oxygen from the red cell at
the tissue level (shifts the curve to the
right)
 ↑2,3 DPG occurs with exercise, hypoxia
(e.g. high altitudes, chronic lung disease)
The Difference between Fetal and Maternal
Hemoglobin for O2 Affinity

 For efficient gas

exchange between a
fetus and it’s
mother,
Fetal hemoglobin has
a higher affinity for
O2 then maternal
hemoglobin.
The Bohr Effect

 When the carbon dioxide content of the

blood increases, the oxygen
dissociation curve shifts to the right.
 This right shift decreases the ability of
hemoglobin to hold oxygen. Consequently,
additional oxygen is unloaded and
made available to the body.
Bohr Effect

 Occurs because decreased pH yields

increase in H+ that combines with
hemoglobin changing its shape and
oxygen cannot bind to hemoglobin
 At the tissues, as more carbon dioxide
enters the blood:
 More oxygen dissociates from
hemoglobin (BOHR EFFECT)
CARBON MONOXIDE
 interferes with oxygen transport by
competing for the same binding sites
 binding with Hb → carboxyhemoglobin
(HbCO)
 has an affinity for hemoglobin (Hgb)
250x that of oxygen
 Effects: normal arterial PO2 but markedly
reduced oxygen content
CARBON MONOXIDE
 dangerous for several reasons:
1. Greater binding affinity for Hb
2. It is odorless, colorless and non irritating
3. Arterial PO2 is normal which prevents any
feedback , mechanism to indicate that
oxygen content is low
4. No physical signs of hypoxemia because the
blood stays bright cherry red when CO binds
with Hb
Carbon Monoxide

 Small partial pressures (Pco =0.4 mmHg)

of CO can decrease oxygen carrying
capacity of Hgb by 50%

 Pco = .6 mmHg can be lethal

CARBON DIOXIDE
TRANSPORT

 means by which blood carries carbon

dioxide from tissues to the blood,
transported back to the lungs
Carbon Dioxide Transport

 Carbon dioxide is transported in the blood

in three forms
 Dissolved in plasma – 7 to 10%
 Chemically bound to hemoglobin – 20% is
carried in RBCs as carbaminohemoglobin
 Bicarbonate ion in plasma – 70% is
transported as bicarbonate (HCO3–)
Transport and Exchange of
Carbon Dioxide
 Carbon dioxide diffuses into RBCs and combines
with water to form carbonic acid (H2CO3), which
quickly dissociates into hydrogen ions and
bicarbonate ions

CO2 + H 2O 
H2CO3  H+ + HCO3–
Carbon Carbonic Hydrogen Bicarbonat
Water
dioxide acid ion e ion
 In RBCs, carbonic anhydrase reversibly catalyzes
the conversion of carbon dioxide and water to
carbonic acid
Transport and Exchange of
Carbon Dioxide
 At the tissues:
 Bicarbonate quickly diffuses from RBCs into the
plasma
 The 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
 At the lungs, these processes are reversed
 Bicarbonate ions move into the RBCs and
bind with hydrogen ions to form carbonic
acid
 Carbonic acid is then split by carbonic
anhydrase to release carbon dioxide and
water
 Carbon dioxide then diffuses from the blood
into the alveoli
Chloride Shift in Tissue
Capillaries
 When RBC’s move through tissue
capillaries, they take in carbon dioxide
nd release bicarbonate.
 As bicarbonate is released, chloride (-1)
shifts into the RBC in order to
replace the negative bicarbonate (-1). This
preserves charge balance in the RBC.
Chloride Shift in Pulmonary
Capillaries
 When RBC’s move through pulmonary
capillaries, they take in bicarbonate and
release carbon dioxide. As bicarbonate (-1)
shifts into the RBC, chloride (-1) shifts
out of the RBC. This also preserves charge
balance in the RBC.

Unit 1 - Objective 7
Transport and Exchange of
Carbon Dioxide
The Haldane Effect

 Removal of oxygen from hemoglobin

increases hemoglobin’s affinity for carbon
dioxide
 This allows carbon dioxide to “ride” on the
empty hemoglobin
Haldane Effect

 the lower the PO2 and hemoglobin

saturation with oxygen, the more carbon
dioxide can be carried in the blood
Haldane Effect

 At the tissues, as more carbon dioxide

enters the blood:
 More oxygen dissociates from hemoglobin (Bohr
effect)
 More carbon dioxide combines with hemoglobin,
and more bicarbonate ions are formed
 This situation is reversed in pulmonary
circulation
 Bohr Effect - Carbon Dioxide effects
oxygen transport

 Haldane Effect - Oxygen levels effect

carbon dioxide
transport
Oxygen-Hemoglobin
Dissociation Curve at Rest
 P50 ↑
↑ 2,3DPG

↓ 2,3DPG
HYPOXEMIA
MECHANISM EXAMPLE
↓ alveolar PO2 Living at high altitude

Hypoventilation Neuromuscular disease

Sedatives
COPD
V/Q mismatch Fibrosis
Pulmonary embolism
Pulmonary edema
Venous admixture Right-to-left cardiac
shunt
↓ O2 carrying capacity Anemia
CO poisoning
HYPOXIA

1. Hypoxic hypoxia
2. Anemic hypoxia
3. Circulatory hypoxia
4. Histotoxic hypoxia
“The real reason dinosaurs
became extinct…”