TRANSPORT OF OXYGEN AND

CARBON DIOXIDE IN THE

BLOOD AND BODY FLUIDS

CAESAR ANTONIO O. LIGO, MD

SILLIMAN UNIVERSITY SCHOOL OF MEDICINE
DUMAGUETE CITY, PHILIPPINES
 INTRODUCTION

 Oxygen alveoli hemoglobin

 30–100x more oxygen
 Tissue cells Carbon dioxide plasma
 15-20x more carbon dioxide
 PRESSURES OF OXYGEN AND CARBON
DIOXIDE IN THE LUNGS, BLOOD, AND TISSUES

 Diffusion
 Pressure difference

Movement of O2 from alveoli to pulmonary capillaries; and from

peripheral capillaries to tissues.
Movement of CO2 from tissues to peripheral capillaries; and from
pulmonary capillaries to alveoli.
Transport of O2 and CO2 by the blood depends on: (1) diffusion,
(2) movement of blood.
 UPTAKE OF OXYGEN BY THE
PULMONARY CAPILLARY BLOOD

Alveolus PO2 = 104 mm Hg

PO2 = 40 Pulmonary Capillary PO2 = 104

Arterial End Venous End

110 Alveolar oxygen partial pressure

Blood PO2 (mm Hg)

100
90
80
70
60
50
40
 UPTAKE OF OXYGEN BY THE PULMONARY
BLOOD DURING EXERCISE

 Exercise
 oxygen demand increases 20x
 increased cardiac output, less transit time
of blood in the pulmonary capillaries
 Safety factors
 increased surface area of capillaries, increasing
diffusing capacity of O2 3x
 nearly ideal V/Q ratio
 blood almost saturated with O2 first 1/3 of
the pulmonary capillary
TRANSPORT OF OXYGEN IN THE ARTERIAL BLOOD

104 mm Hg Mixed with pulmonary shunt

100 blood (venous admixture)

95 mm Hg

80 Venous
blood

Pulmonary Arterial Systemic Venous

60
Capillaries Blood capillaries Blood
PO2

40

20

Venous admixture: Non-oxygenated blood (40 mm Hg) from bronchial circulation + oxygenated blood (104 mm Hg) from pulmonary veins.
 DIFFUSION OF OXYGEN FROM THE
PERIPHERAL CAPILLARIES TO THE TISSUE FLUID

Arterial end of 40 mm Hg
Venous end of
capillary capillary

PO2 = 95 mm Hg PO2 = 40 mm Hg

23 mm Hg
 EFFECT OF RATE OF BLOOD FLOW
Interstitial Fluid PO2 (mm Hg) ON INTERSTITIAL FLUID PO2

100 Upper limit of infinite blood flow

80 ¼ normal O2 consumption

B
60
Normal O2 consumption
A
40
4x normal O2 consumption
20

C
0

0 100 200 300 400 500 60 700

Blood Flow (per cent of normal)
 TISSUE OXYGEN

 rate of oxygen transport to the

tissues in the blood (blood flow)
 rate at which oxygen in used by the
tissues (metabolism)
 DIFFUSION OF O2 FROM THE PERIPHERAL
TISSUE CAPILLARIES TO THE TISSUE CELLS

 O2 always being used by cells

 Intracellular pO2 < Capillary pO2
 Distance between capillaries and cells
 Range: 5-40 mm Hg (Ave: 23 mm Hg)
 Cellular O2 consumption: 1-3 mm Hg
 Normal PaO2 = 80-100 mm Hg

Differences in oxygen concentration and utilization provide more than adequate

and large safety factor.
DIFFUSION OF CO2 FROM THE PERIPHERAL TISSUE CELLS INTO
THE TISSUE CAPILLARIES AND FROM THE PULMONARY
CAPILLARIES IN THE ALVEOLI

Oxygen Carbon Dioxide Tissue Capillaries

Alveoli Pulmonary Capillaries Lungs

Arterial End of Venous End

45 mm Hg
Capillary of Capillary

40 mm Hg 46 mm Hg 45 mm Hg

Uptake of Carbon Dioxide by the Blood in the Tissue Capillaries

DIFFUSION OF CARBON DIOXIDE FROM THE
PULMONARY BLOOD INTO THE ALVEOLUS

Alveolus pCO2 = 40 mm Hg

pCO2 = 45 mm Hg pCO2 = 40 mm Hg
Pulmonary Capillary

Arterial End Venous End

45
Blood pCO2 (mmHg)

44
43
42
41
Pulmonary Capillary Blood
40
Alveolar carbon dioxide partial pressure
EFFECT OF TISSUE METABOLISM AND
BLOOD FLOW ON INTERSTITIAL PCO2
Interstitial Fluid pCO2 (mm Hg)

120
100
80
B 60 mm Hg 10x normal metabolism
60 41 mm Hg

A 45 mm Hg
Normal Metabolism C
40
Lower limit of infinite blood flow
20 ¼ normal metabolism

0
100 200 300 400 500 600
Blood Flow (per cent of normal)
 TRANSPORT OF OXYGEN
IN THE BLOOD

 97% of oxygen carried with Hgb

 3% of oxygen dissolved in plasma
 Pulmonary capillaries: Hgb:O2
 Tissue capillaries: Hgb O2
Hemoglobin and rbc’s
 Hemoglobin and rbc’s

• 30 trillion RBC’s with

each RBC having a
volume of 90fL. One-
third of a RBC volume is
hemoglobin.
• 270 million hemoglobin
molecules/RBC
 OXYGEN-HEMOGLOBIN DISSOCIATION CURVE
100 1
20
Percentage of Saturation

Oxygenated
90 blood leaving
the lungs
80 16
2

Volumes Per Cent

70
12
60
50
Reduced blood 8
40 returning from
the tissues
20
4
10
0 2
10 20 30 40 50 60 70 80 90 100 110 120 130

Gas Pressure of oxygen (mm Hg)

 MAXIMUM AMOUNT OF OXYGEN THAT CAN
COMBINE WITH THE HEMOGLOBIN OF THE BLOOD

 Hgb = 15 gm/100 ml of blood

 1 gm Hgb = 1.34 ml of O2
 15 x 1.34 = 20.1 ml of O2 /100ml of
blood (100% saturation)
 19.4 ml of O2/100 ml of blood (97%
saturation
 5 ml of oxygen/100 ml of blood
= transported from lungs to tissues
 OXYGEN-HEMOGLOBIN DISSOCIATION CURVE

20
18
16 Venous blood in exercise
Oxygen in Blood (vol%)

14

Normal Arterial Blood

Normal Venous Blood
12
10
8
6
4
2
10 20 30 40 50 60 70 80 90 100 110 120 130
Gas Pressure of oxygen (mm Hg)
Effect of blood oxygen pressure on the quantity of oxygen bound with Hgb in each 100 ml of blood
 UTILIZATION COEFFICIENT

 The percentage of blood that gives

up oxygen as it passes through the
tissue capillaries
 N = 25%
 Exercise = 75-85%
 Low blood flow/high metabolic rate = 100%
 Effect of Hemoglobin to
“Buffer” the Tissue pO2

 Tissue pO2 normally does not rise above

40 mm Hg*
 Little changes in tissue pO2 occur even
when there is marked change in
atmospheric oxygen concentration

*Hemoglobin sets an upper limit on the pO2 in the tissues.

 Effect of Hemoglobin to
“Buffer” the Tissue pO2

 During exercise
 hemoglobin delivers oxygen 20x normal
 with little further decrease in tissue oxygen (compensated
by an increase in tissue blood flow)

Hemoglobin in the blood automatically

delivers oxygen to the tissues between 15-40
mm Hg.
 Effect of Hemoglobin to
“Buffer” the Tissue pO2

 Marked changes in
atmospheric oxygen
concentration
• buffer effect of
hemoglobin still
maintains almost
constant tissue oxygen

Even when there is marked fall

in alveolar pO2 from 104 to 60
mm Hg, or marked increase from
104 to 500 mm Hg.
 FACTORS THAT SHIFT THE OXYGEN-
HEMOGLOBIN DISSOCIATION CURVE
 BOHR EFFECT
EFFECT OF CO2 AND H+

 A decrease in oxygen affinity of

hemoglobin when the pH of blood falls.
 A deoxygenated hemoglobin binds H+
more actively than an oxyhemoglobin.
 H+ = CO2

Niels Henrik David Bohr: 7 October 1885 – 18 November

1962) was a Danish physicist who made foundational
contributions to understanding atomic structure and
quantum theory, for which he received the Nobel Prize in
Physics in 1922.
 BOHR EFFECT
As blood passes through the lungs, CO2 diffuses
from the blood to the alveoli

Decreased blood CO2

and decreased H+

Increased binding of O2
to hemoglobin

As blood reaches the tissue

capillaries, CO2 enters the
blood from the tissues

Oxygen displaced from hemoglobin

2,3-DIPHOSPHOGLYCERATE (DPG)

Found mostly in RBCs

Formed during glycolysis (Embden-
Meyerhof pathway)
Highly charged ion that binds to the b-
chains of deoxyhemoglobin
Increased by: thyroid hormones, growth
hormone, androgens, high pH, and
especially tissue hypoxia

Gustav Embden (1874-1933). German Otto Meyerhof (1884-1951). German doctor

Chemist. Never won a Nobel Prize even and biochemist. Awarded Nobel Prize in
if he was nominated 12 times in 8 years. Medicine in 1922.
 EXERCISE

 Exercising muscles release 2,3,-DPG,

CO2, and other acids
 Exercising muscles increase its
temperature by 2o-3o C, increasing its
oxygen delivery
TRANSPORT OF CO2 IN THE BLOOD

4 ml of CO2/100 ml of blood are transported

from the tissues to the lungs (normal resting
condition).

Chemical forms CO2 is transported:

 dissolved state (0.3 ml, 7% of all CO2)
 bicarbonate ion (70% of all CO2)
 carbaminohemoglobin (23% of all CO2)
Carbonic Anhydrase

Cl-
 HALDANE EFFECT

 Opposite of Bohr Effect

 Binding of oxygen with hemoglobin
tends to displace carbon dioxide
from the blood
 More important in promoting CO2
transport than is Bohr effect in
promoting O2 transport
John Scott Haldane :(2 May 1860 – 15 March 1936) was a Scottish physiologist famous for intrepid self-experimenting
which led to many important discoveries about the human body and the nature of gases.He also used his son J. B. S.
Haldane as a guinea pig, even when he was quite young.Haldane locked himself in sealed chambers breathing potentially
lethal cocktails of gases while recording their effect on his mind and body.
Haldane visited the scenes of many mining disasters and investigated their causes. When the Germans used poison gas in
World War I Haldane went to the front at the request of British secretary of state, Lord Kitchener and attempted to
identify the gases being used. One outcome of this was his invention of the first gas mask.
 HALDANE EFFECT

 combination of oxygen with hemoglobin in

the lungs causes the hemoglobin to become
a stronger acid
 displaces CO2 from the blood into the alveoli
 more acidic Hgb has less tendency to combine with CO2
to form carbaminohemoglobin, displacing much of CO2 that
is present in the carbamino form from the blood
 more acidic Hgb causes it to release an excess of hydrogen
ions, which bind with HCO3 ions to form H2CO3,
then dissociates into H2O and CO2
 HALDANE EFFECT

 Tissues capillaries: increased pick-up of CO2 because

O2 removal from the hemoglobin
 Lungs: increased release of CO2 because of O2
pick-up by the hemoglobin
 HALDANE EFFECT
EFFECT ON THE TRANSPORT OF CO2 FROM THE TISSUES TO THE LUNGS

CO2 in blood volumes per cent

55
pO2 = 40 mm Hg
(tissues)

52 A
pO2 = 100 mm Hg
50 (lungs)

48
B

45
35 40 45 50

pCO2
The Haldane effect doubles the amount of CO2 released from the blood in the lungs, and doubles pick-up of CO2 in the tissues.
 RESPIRATORY EXCHANGE RATIO

Ratio of CO2 output to O2 intake

Rate of Carbon Dioxide Output

R=
Rate of Oxygen Uptake
R = 0.825

O2 transport from the lungs to tissues: 5 ml/100 ml of blood

CO2 transport from tissues to the lungs: 4 ml/100 ml of blood