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3 O 2 and CO 2 Transport M1 Cardiovascular/ Respiratory Sequence Louis D Alecy, Ph.D. Fall
4 Tuesday 11/18/08, 9:00 O 2 and CO 2 Transport 35 slides, 50 minutes 1. Describe the amount of oxygen dissolved and combined in blood. 2. Define oxygen delivery to a tissue. 3. Describe the characteristics of the oxygen-hb saturation curve. 4. Describe the shifts produced in the oxygen-hb saturation curve. 5. Describe the effects of anemia on oxygen content and PO State the three forms in which CO 2 is carried in the blood. 7. Describe the role of carbonic anhydrase in CO 2 transport. 8. Describe the chemical events associated with the uptake and release of CO Defines chloride shift. 4
5 Liquid blood Alveolar gas Source Undetermined O 2 content of blood = Dissolved + Hb bound O 2 5
6 How much gas is dissolved? A gas dissolves in a liquid in direct proportion to its partial pressure and solubility. Henry s Law 6
7 Henry s Law for O 2 The content of dissolved oxygen is equal to the product of the oxygen solubility coefficient and oxygen partial pressure. CdO = a O2 P O 2 Linear straight line Relationship like y = mx. = CdO2 content of dissolved O 2 ml/dl a 2 = solubility coefficient for O 2 in blood a O2 = ml/mm Hg/dL dl = 100 ml 7
8 Dissolved O 2 At PO 2 of 100 mmhg X you get 0.3 ml O 2 /dl dissolved oxygen in blood. With cardiac output of 5000 ml/min or 50 dl/min you would deliver (50 dl X 0.3 ml/dl) or 15 ml O 2 /min. BUT We consume 20 X that or 250 ml O 2 /min so dissolved just will not do it!! You need hemoglobin to bind and transport O 2. dl = 100 ml 8
9 Zephyris (wikipedia), Hemoglobin 9
10 Air Air Plasma Dissolved only D Alecy RBC Hb-O 2 bound + O 2 dissolved Not all Hb has O 2 10
11 How much O 2 is in blood? Concentration = Content ml/dl = ml/100ml = Vol% (ml of O 2 in 100 ml blood) i.e. arterial blood has 20 Vol% O 2 Content %Hb Saturation % Hb Saturation = O 2 bound to Hb X 100% O 2 capacity of Hb 11
12 O 2 content (with flow) determines O 2 delivery. Thus O 2 content is more important to O 2 delivery than is O 2 saturation. O 2 Content %Hb Saturation So why do we talk about O 2 saturation? O 2 saturation is relatively easier to measure and O 2 content is much more difficult to measure. We need to understand the differences!!!! 12
13 Hb Saturation Curve Normal Arterial Blood ~ 27 mmhg Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 13
14 % Hb Sat Or Sat Most O 2 combined. Linear straight line relationship. O 2 Content (ml / 100mL) Source Undetermined 14
15 O 2 Content (ml / 100mL) Different amounts of Hb but all 100% saturated! H b O 2 Saturation (%) Hb=10 Hb=15 Hb=20 Normal blood Hb = 15 gm/dl Source Undetermined 15
16 DO 2 (cc/m 2 /min) Anemia or Blood loss CI (L/m 2 /min) Bartlett, Critical Care Physiology 16
17 i.e. ANEMIA Decreased Hb concentration so that % saturation can be normal (97-100%) but O 2 content is decreased. 1. Decreased number of RBC 2. Decreased Hb content per RBC Normal blood Hb = 15 gm/dl 17
18 Denver? O 2 bars? O 2 Content (ml / 100mL) Source Undetermined Breathing 100% O 2. 18
19 Hemoglobin Bound Oxygen Content ml O 2 /dl C b O = S O 2 [ Hb ] Hb s 2 S O = % Hb saturation = O 2 bound to Hb X 100% O 2 capacity of Hb [ Hb ] = hemoglobin content gm/dl blood Hb s = saturated Hb O 2 content ml O 2 /gm Hb Hb s = 1.36 ml O 2 /gm Hb = O 2 capacity 19
20 Typical Arterial Blood Oxygen Content P O Dissolved O = 100 mm Hg S = 97% [ Hb ] = 15 gm/dl O 2 2 C d O 2 Bound O = a O 2 P O 2 = x 100 = 0.31 ml / dl C = S [ Hb ] Hb = 0.97 x 15 x 1.36 = ml / dl b O s O 2 2 Total Oxygen Content C d O 2 + C b O 2 = = 20.1 ml / dl 20
21 Bound Cb O ml / dl 20.1 Dissolved Cd O Total C O H b O 2 Saturation (%) % Source Undetermined 21
22 Content P ao2 C ao2 S O2 mm Hg ml / dl % Normal Hb 15 g/dl Breathing Room Air Anemia Hb 7.5 g/dl Breathing 100% O 2 Normal Hb 15 g/dl Anemia Hb 7.5 g/dl Thus breathing 100% O 2 does not fix reduced oxygen transport capacity due to anemia. 22
23 2X or 3X CO could compensate DO 2 (cc/m 2 /min) Anemia or Blood loss CI (L/m 2 /min) Bartlett, Critical Care Physiology 23
24 ph on O 2 Saturation of Hb Acid unloads O 2 from Hb (Bohr Effect) At any PO 2 less O 2 bound Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 24
25 CO 2 on O 2 Saturation of Hb CO 2 unloads O 2 from Hb (Bohr Effect) At any PO 2 less O 2 bound Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 25
26 Temperature on O 2 Saturation of Hb Temperature unloads O 2 from Hb At any PO 2 less O 2 bound Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 26
27 2,3-BPG on O 2 Saturation of Hb More 2,3-BPG unloads O 2 from Hb Lost in stored blood ~ canʼt unload O 2 Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 27
28 Venous blood on O 2 Saturation of Hb Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Venous blood unloads O 2 from Hb P 50 is PO 2 at 50% O2 saturation. 28
29 left shift (lungs) H + CO 2 temperature 2,3 BPG At any PO 2 more O 2 bound. right shift (tissues) Source Undetermined At any PO 2 less O 2 bound. 29
30 O 2 is unloaded in tissues O 2 HbO 2 D Alecy tissue metabolism right shift + H Temperature CO 2 30
31 In tissues CO 2 is stored in blood (for transport). CO 2 CO 2 CO 2 + H 2 O H 2 CO 3 C.A. = carbonic anhydrase chloride Shifts in Cl - HCO H + HbO 2 Bohr shift Buffer Action. O 2 O 2 O 2 + HHb tissue ISF plasma RBC Source Undetermined In tissues O 2 is unloaded from blood. 31
32 In lungs CO 2 is unloaded from blood. CO 2 CO 2 CO 2 + H 2 O chloride Shift out HCO 3 - H 2 CO 3 HCO H + Cl - C.A. = carbonic anhydrase HbO 2 Haldane shift O 2 O 2 O 2 + HHb alveolus plasma RBC Source Undetermined In lungs O 2 is stored in blood. 32
33 How is CO 2 Transported? CO 2 is about 20 x more soluble than O 2 But still only 5% (art.) to 10% (ven.) of transport is dissolved!! The content of dissolved gas (C dx ) is the product of the solubility coefficient (a x ) and the partial pressure of the gas (P x ). Cdx = a x P x Cdx = dissolved gas content ml/dl a O2 = ml / mm Hg /dl = 0.06 ml / mm Hg /dl a CO2 33
34 Some Most Carbonic Anhydrase H + + Hb-NHCOO - = Hb + CO 2 + H 2 O = H + + HCO3 - Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 34
35 Reduced (de-ox)hb binds more CO 2 than HbO 2 Source Undetermined 35
36 Source Undetermined 36
37 Reduced (de-ox)hb binds more CO 2 than HbO 2, venous blood can carry more CO 2 then arterial blood. Venous Venous blood Arterial blood Arterial Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. 37
38 left shift (lungs) H + CO 2 temperature 2,3 BPG At any PO 2 more O 2 bound. right shift (tissues) Source Undetermined At any PO 2 less O 2 bound. 38
39 Slide 5: Source Undetermined Slide 9: GFDL, Zephyris (wikipedia), Slide 10: D Alecy Slide 13: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 14: Source Undetermined Slide 15: Source Undetermined Slide 16: Bartlett, Critical Care Physiology Slide 18: Source Undetermined Slide 21: Source Undetermined Slide 23: Bartlett, Critical Care Physiology Slide 24: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 25: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 26: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 27: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 28: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 29: Source Undetermined Slide 30: D Alecy Slide 31: Source Undetermined Slide 32: Source Undetermined Slide 34: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 35: Source Undetermined Slide 36: Source Undetermined Slide 37: Levitzky. Pulmonary Physiology. McGraw-Hill, th ed. Slide 38: Source Undetermined Additional Source Information for more information see:
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