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Oxygen yg transport p Oxyhaemoglobin dissociation curve Carbondioxide transport Tissue hypoxia

O2 transport
1. Dissolved O2 : 3.5% 3 5% O2 : 100 ml dissolved O2 = 0.003 ml

2. Oxyhemoglobin (HbO2) : 95-97% O2

(polypeptide chain )

1 subunit

Hb + O2 Deoxyhemoglobin

PaO2 1 mmHg (0.003 vols%)

HbO2 oxyhemoglobin

PaO2 100 mmHg

dissolved O2 = 0.3 0 3 ml/100 ml of blood

CO 5 l/min dissolved O2 = 15 ml (VO 2 250 ml/min)

Fe 2+
nitrites, sulfonamides

Fe3+ (methemoglobin)

HbO2

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Oxyhaemoglobin dissociation curve

Association part

Normal: Hb 15 g% Hb 1 g combine O2 = 1.39 ml O2 capacity = Hb combine O2 = 20.8 ml: blood 100 ml

Hb O2

SaO2 = 100%

Dissociation part

O2 saturation of Hb (O2 Sat), % = O2 combined with Hb x 100 O2 capacity

PaO2 40 mmHg, SaO2 75% PaO2 50 mmHg, SaO2 83.5% PaO2 60 mmHg, SaO2 89% PaO2 80 mmHg, SaO2 94.5% PaO2 100 mmHg, SaO2 97.5%

(100%O2)

Bohr effect

P50 (SaO2 =50%)

2,3-Diphosphoglycerate (2,3-DPG) (also 2,3bisphosphoglycerate or 2,3-BPG) : is organophosphate, g p p which is created in erythrocytes y y during g glycolysis

2,3-DPG
P50 (curve shift to right) P50 (curve shift to left) : presence of diminished peripheral tissue O2 availability, hypoxaemia, chronic lung disease, anaemia, and congestive heart failure

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Anemia : %SaO2, PaO2 : O2 content O2 transport COHb : CO Hb O2 O2 transport t t Methemoglobin Fe3+ O2 transport : Fe2+ HbF : HbF O2 HbA O2 transport

CO2 transport
1. Dissolved CO2 : 5% CO2 : 100 ml dissolved CO2 = 0.06 ml

PaCO2 1 mmHg

PaCO2 40 mmHg

dissolved CO2 = 2.4 2 4 ml/100 ml of blood

2. Bicarbonate : 90 % CO2 CO2 + H2O

CA

H2CO3

+ H + HCO 3

3. Carbamino compounds : 5% CO2 H R-N + CO2 R-N COOCarbamino compound H Terminal amine group H + H+

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Tissue hypoxia 1. Hypoxic hypoxia (anoxic hypoxia) : Alveolar hypoventilation Myasthenia gravis, obstructive lung disease pulmonary y edema : Diffusion defect p : Shunt : V/Q inequality 2. Anemic hypoxia : Anemia : Carbonmonoxide poisoning y hypoxia yp ( (stagnant g hypoxia) yp ) 3. Circulatory : Low blood flow shock,
PCO2 CO2 transport

Deoxygenated blood

CO2 transport (Haldane effect)

congestive heart failure 4. Histotoxic hypoxia (cellular hypoxia) : O2 cyanide

O2
1. Hypoxic hypoxia - Low PAO2 - Diffusion impairment - Right-to-left shunts - V/Q mismatch

PAO2

PaO2

CaO2

PvO2

CvO2

FiO2 O2

Low Normal Normal Normal

Low Low Low Low Normal Normal Normal Normal

Low Low Low Low Low Low

Low Low Low Low Low Low

Low Low Low Low Low Low Low High

Yes Yes No Yes No Possible No No

yp Normal 2. Anemic hypoxia - CO poisoning 3. Hypoperfusion hypoxia 4. Histotoxic hypoxia Normal Normal Normal

Normal Low Normal High