O2/ C02 Transport
Oxygen Transport
Oxygen Loading
One oxygen molecule is picked up by each hemoglobin in the red blood cell.
This occurs in the alveoli where oxygen enters the blood.
Hemoglobin can carry up to four oxygen molecules, but initially starts with three after releasing one to the tissues.
Red blood cells, after being recharged with oxygen, travel back to the left side of the heart.
Oxygen Delivery
Hemoglobin releases one oxygen molecule to tissues.
The process repeats, with carbon dioxide transported back to the lungs.
Carbon Dioxide Transport
Introduction to Carbon Dioxide Transport
More complex than oxygen transport.
Carbon dioxide is transported in three primary ways.
1. Dissolved in Plasma
Small amount of carbon dioxide enters the plasma directly.
Least common method of transport (about 10% of carbon dioxide).
2. Binds to Hemoglobin (Carbamino Compounds)
Carbon dioxide enters the red blood cell and binds to the globin part of hemoglobin (not the iron part).
This compound is called carbaminohemoglobin.
About 20-30% of carbon dioxide is transported this way.
3. Converted to Bicarbonate (Most Complex Process)
Inside the red blood cell, carbon dioxide combines with water to form carbonic acid (H2CO3), a process catalyzed by the enzyme carbonic anhydrase.
Carbonic acid is unstable and dissociates into hydrogen ions (H+) and bicarbonate ions (HCO3-).
The release of hydrogen ions can create a strong acidic environment.
Hydrogen ions bind with hemoglobin to buffer the pH.
Bicarbonate ions are transported out of the cell through a chloride shift, where chloride ions (Cl-) enter the cell to maintain electrical neutrality.
This process accounts for approximately 70% of carbon dioxide transport.
Reversal at the Lungs
Exhalation of Carbon Dioxide
At the lungs, carbon dioxide must be reversed back to its gaseous form for exhalation.
1. Dissolved Carbon Dioxide: Easily released from plasma to alveoli.
2. Carbaminohemoglobin: Carbon dioxide dissociates from hemoglobin; hemoglobin remains, and carbon dioxide is freed to enter the alveoli.
3. From Bicarbonate:
Bicarbonate ions are transported back into the red blood cell, chloride ions exit.
Bicarbonate combines with hydrogen ions to reform carbonic acid, which then breaks down into water and carbon dioxide.
Carbon dioxide is then released into the alveoli for exhalation.
Clinical Relevance
Understanding carbon dioxide transport is critical in clinical settings, especially for nursing students.
The interaction between carbon dioxide, water, and carbonic acid regulates blood pH, which affects various pathophysiological conditions (e.g., respiratory acidosis, alkalosis).
Future clinical applications include calculating bicarbonate and pH levels based on carbonic acid equilibrium, crucial for patient care.