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CO
CO22 60 50 45 40 40 32 0.3
RBC Plasma
R-NH2 CO CO2 CO Alveo Alveol
11% 2 1 45 mmHg
R-NHCOO- H O dissolved CO2 CO2
CA as 2
+ H+ H COe 5% 40 mm Hg
2 3 2
Alkaline Bohr plasma
RNHCO2
- 100 mm
+ H+
+ HCO 3 3
HCO3- O2
HbO2 HHb + Cl- 70%
90% vol.
O
arterial 96% sat. 2
Cl-
(H2O)
O2
0.3Vol%
2,3-diphosphoglycerate
Is plentiful in RBCs, with t1/2 of 6hrs
Is a highly charged ion that binds to the beta
chains of deoxyhemoglobin, to release oxygen
Its conc is Alkalosis, Thyroid hormones,
Growth hormones, Androgens, exercise, ascent
to high altitudes, and in diseases characterized
by chronic hypoxia e.g. anemia.
Its conc is by acidosis
Preserved in blood bank by citrate-phosphate-
dextrose solution.
Fetal Hb
HbF has greater affinity for O2 than HbA,
to facilitate movement of O2 from the
mother to the fetus
This is due to poor binding of the 2,3-
DPG by the polypeptide chains that
replace - chains in fetal Hb.
Myoglobin
An iron containing pigment found in skeletal
muscles, especially those specialized for
sustained contractions.
Resembles Hb but bind to 1 rather than 4 moles
of O2 per mole.
Its dissociation curve is a rectangular hyperbola,
to the Left of the Hb curve.
It takes up O2 from Hb in the blood
Releases O2 only at very low PO2, e.g. in
exercising muscles
Hb & Myoglobin dissociation curve
CO Poisoning
CO combines with Hb at the same point on the
Hb molecule as does O2, thereby displacing O2,
and its O2 carrying capacity
CO has 250x more binding affinity to Hb as
compared to O2. It combines with Hb at very low
partial pressures (0-0.4mmHg).
Even though O2 content in blood is greatly in
CO poisoning, but the PO2 may be normal.
This makes exposure to CO especially
dangerous, because blood is bright red, and no
signs of hypoxemia e.g. cyanosis.
CO poisoning
As a consequence, the feedback mechanism that
usually stimulate RR in response to lack of O2 is
absent.
Pt may become disorientated, unconscious, and
even die without any feedback respiratory
response.
Treatment is usually by giving pure O2, because
O2 at high alveolar pressure can displace CO from
its combination with Hb.
Simultaneous administration of 5% CO2 stimulate
the Respiratory centre to alveolar ventilation,
and reduce alveolar CO2
Carbon dioxide Transport
The solubility of CO2 in blood is 20x that of O2.
So there is considerable more CO2 than O2 in
simple solution at equal partial pressures.
Under normal resting conditions, 4mls of CO2 is
transported from the tissues to the lungs in each
100mls of blood. Equivalent to 200mls of CO2 in
each 5L of blood.
However, CO2 in blood has a lot to do with acid-
base balance of the body fluids.
Chemical forms of CO2 transport in
blood
CO2 is transported in 3 different forms
1.Small amount is transported in dissolved form in
plasma, as CO2 molecule.
2.7mls/dl at 45mmHg in venous blood, and
2.4mls/dl at 40mmHg in arterial blood.
Therefore, only about 0.3mls of CO2 is transported in
dissolved state for each 100ml of blood.
2.As bicarbonate ion. Account for 70% of CO2 transport
3.In combination with Hb and plasma proteins. Account
for about 11% of CO2 transport
As bicarbonate ion
Dissolved CO2 in RBC quickly react with water-
in the presence of Carbonic Anhydrase, to form
Carbonic acid.
In another fraction of a second, the carbonic acid
formed in the red cells (H2CO3) dissociates into
hydrogen and bicarbonate ions (H+ and HCO3)
Most of the H+ combine with Hb in RBC, bse Hb
is a powerful acid-base buffer
Many of the HCO3- diffuses into plasma, while in
exchange Cl- diffuses into RBC.
Thus, Cl- content is higher in venous RBCs than
in arterial RBCs. A phenomenon called Chloride
shift.
In combination with Hb & plasma
proteins
Some of the CO2 in RBC reacts with amino
groups of Hb, forming carbaminohemoglobin
(CO2Hgb)
This combination of carbon dioxide and
hemoglobin is a reversible reaction that occurs
with a loose bond,
carbon dioxide is easily released into the alveoli,
where the PCO2 is lower than in the pulmonary
capillaries
CO2 also reacts similarly with plasma proteins.
However, this is not significant.
CO2 uptake
Release of CO2 in the lungs
Binding of oxygen with hemoglobin tends to
displace carbon dioxide from the blood. This
effect, called the Haldane effect,
This effect is quantitatively far more important in
promoting carbon dioxide transport than is the
Bohr effect in promoting oxygen transport.
It results from the simple fact that the
combination of oxygen with hemoglobin in the
lungs causes the hemoglobin to become a
stronger acid.
This displaces carbon dioxide from the blood and
into the alveoli in two ways
CO2 Release..
1. The more highly acidic hemoglobin has less tendency to
combine with carbon dioxide to form
carbaminohemoglobin, thus displacing much of the
carbon dioxide that is present in the carbamino form
from the blood.