Oxygen and Carbon Dioxide Transport in the Blood

Michael Donahoe MD
www.pitt.edu/~paccm/medicalstudent.htm

Partial pressure
Index of molecular motion of a gas Diffusion of a gas is proportional to the pressure gradient

O2 CO2

O2 CO2

Oxygen Transport

Dissolved oxygen
Linear relationship 0.003 ml 02 / 100 ml blood x P02

Chemical combination with Hg

Non - linear relationship 1.34 ml 02 / 100 ml blood x Hgb x % sat

PO2 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

% sat of Hgb 13.5 35.0 57.0 75.0 83.5 89.0 92.7 94.5 96.5 97.4

02 with Hgb 2.7 7.0 11.5 15.1 16.8 17.9 18.6 19.0 19.4 19.6

dissolved O2 0.03 0.06 0.09 0.12 0.15 0.18 0.21 0.24 0.27 0.30

Saturation

Calculated
ml O2 combined with Hgb
maximum ml O2 combined with Hgb

x 100

Measured

PaO2 vs SaO2
Physiological significance Clinical significance

PaO2 vs SaO2

Oxygen diffusion (PaO2)

Lung (A-a) Tissues

Oxygen transport (SaO2)

Arterial oxygen content Venous oxygen content

Oxygen Transport

Arterial oxygen content (CaO2

Arterial oxygen delivery (DO2)
CaO2 x cardiac output (CO)

ml/dL

Hgb associated O2 + dissolved O2

Venous oxygen content (CvO2) ml/dL

Arterial oxygen content (CaO2) ml/dL

Hgb associated O2 +
dissolved O2

Hgb associated O2 +
dissolved O2

PAO2
(A-a) Gradient

PaO2
Arterial oxygen delivery (DO2) ml/min CaO2 x cardiac output (CO)

Venous oxygen delivery (DO2) ml/min CvO2 x cardiac output (CO)

V02

Tissue oxygen uptake (V02)

V02 = {(CaO2) - (CvO2)} CO

Arterial oxygen content (CaO2)
Hgb associated O2 + dissolved O2

Venous oxygen content (CvO2)

Hgb associated O2 + dissolved O2

Venous oxygen content (CvO2) = 15 ml/dL

Arterial oxygen content (CaO2) = 19.5 ml/dL

15 gms/dl x 1.34 ml/gm x 70%

40 x 0.003

15 gms/dl x 1.34 ml O2 /gm x 96%

91 x 0.003

99
8

91

Venous oxygen delivery (DO2) = 750 ml / min 15 gms/dl x 1.34 ml O2/gm x 70% x 50 dL / min

Arterial oxygen delivery (DO2) = 1000 ml/min 19.5 ml / dL x 50 dL / min

V02 = 250 ml/min

DO2
(mm Hg)

PaO2
100

SaO2
(%)

Hgb
(gms/dl)

CO
(dl/min)

(ml/min)

DO2

100

15

50

1020

DO2
(mm Hg)

PaO2
100 50

SaO2
(%)

Hgb
(gms/dl)

CO
(dl/min)

(ml/min)

DO2

100 87

15 15

50 50

1020 882

DO2
(mm Hg)

PaO2
100 50

SaO2
(%)

Hgb
(gms/dl)

CO
(dl/min)

(ml/min)

DO2

100 87

15 15

50 50

1020 882

100

100

7.5

50

518

DO2 (Oxygen Delivery)

(mm Hg)

PaO2
100 50

SaO2
(%)

Hgb
(gms/dl)

CO
(dl/min)

(ml/min)

DO2

100 87

15 15

50 50

1020 882

100
100

100
100

7.5
15

50
25

518
510

O2 Stores

Oxygen Stores
Lung 400 ml Hemoglobin 850 ml

Oxygen Utilization
Tissues 250 ml / min

Carbon Dioxide Transport

Diffusion of CO2 from tissue cells Chemical reactions in the plasma Chemical reactions in the erythrocyte

Carbon Dioxide Transport

Plasma (minor)
Dissolved (0.067 ml CO2 * pCO2) Hydration
H2O + CO2 H2CO3 H+ + HCO3-

Reaction with plasma proteins (carbamino cmpds)

Carbon Dioxide Transport

Erythrocyte (major)
Dissolved Hydration
H2O + CO2 H2CO3 H+ + HCO3 (H+ buffered by Hgb / 02 unloaded = Bohr)

Reaction with NH2 groups of Hg to form carbamino groups

R- NH2 + CO2 R- NHCOO- + H+

Carbon Dioxide Transport

Bohr Effect
H2O + CO2 H+ + HCO3 H+ binds to Hgb Hgb and H+ = Reduces Hgb O2 Affinity

Haldane Effect
Unoxygenated Hgb favors CO2 + Hgb to carbamino compounds

Gas Transport

Haldane
Hgb Hb + O2
Better buffer Promotes carbamino compounds

Bohr
H2O + CO2
Unloads O2

H2CO3

H+ + HCO3-

Gas Transport

Haldane
Oxygen saturation influences CO2 content

Bohr
CO2 content influences O2 saturation

CO2 Stores

Carbon Dioxide Stores (> 100 liters)

Dissolved (plasma and RBC) HCO3- plasma, cells, interstitial fluid Bone

Carbon Dioxide Production

Tissues 200 ml / min

O2 CO2

O2 CO2