Gas

Exchange
&Transport
Dr . Amro
 O2 and CO2 exchange by
O2 and CO2 exchange by diffusion
diffusion
 The process of diffusion is simply the
random motion of molecules
intertwining their way in all directions
through the respiratory membrane
and adjacent fluids.
 For diffusion to occur, there must be a
source of energy. This is provided by
the kinetic motion of the molecules
themselves.
Net Diffusion of a Gas in One
Direction—Effect of a
Concentration Gradient

net diffusion of the gas will

occur from the high-
concentration area toward
the low-concentration area
 Gas Pressures in a Mixture of Gases
“Partial Pressures”
of Individual Gases
 the pressure is directly proportional to the
concentration of the gas molecules.
 Atmospheric pressure = 760 mmHg at sea level
 Oxygen is 21% of atmosphere 760
mmHg x .21 = 160 mmHg PO2
 Carbon dioxide is 0.04% of atmosphere 760
mmHg x .0004 = 0.3 mm Hg PCO2
 Pressures of Gases Dissolved
in
Water and Tissues
 The partial pressure of a gas in a solution is determined
not only by its concentration but also by the solubility
coefficient of the gas.
 Henry’s law:
Partial pressure = Concentration of dissolved gas
Solubility coefficient
Solubility coefficient for some gases:
 Oxygen 0.024 Carbon dioxide 0.57
 Carbon monoxide 0.018 Nitrogen 0.012
 Helium 0.008
 Diffusion of Gases Between the Gas
Phase in the Alveoli and the
Dissolved Phase in the Pulmonary
Blood
 net diffusion is determined by the difference
between the two partial pressures
 If the partial pressure is greater in the gas phase
in the alveoli, as is normally true for oxygen, then
more molecules will diffuse into the blood than in
the other direction. Alternatively, if the partial
pressure of the gas is greater in the dissolved
state in the blood, which is normally true for
carbon dioxide, then net diffusion will occur
toward the gas phase in the alveoli.
 Composition of Alveolar Air---Its
Relation
to Atmospheric Air
Alveolar air does not have the same
concentrations of gases as atmospheric air by any
means for the following reasons:
 First the alveolar air is only partially replaced by
atmospheric air with each breath.
 Second, oxygen is constantly being absorbed into the
pulmonary blood from the alveolar air.
 Third, carbon dioxide is constantly diffusing from the
pulmonary blood into the alveoli. And
 fourth, dry atmospheric air that enters the respiratory
passages is humidified even before it reaches the alveoli.
 Humidification of the Air in the
Respiratory Passages

The partial pressure of water vapor at a normal

body temperature of 37°C is 47 mm Hg this
water vapor simply dilutes all the other gases
in the inspired air
 Diffusion of Gases Through
the Respiratory Membrane
 Respiratory Unit :
composed of a respiratory
bronchiole, alveolar ducts,
atria, and alveoli
 There are about 300
million alveoli in the two
lungs, and each alveolus
has an average diameter
of about 0.2 millimetre.
Diffusion of Gases Through
the Respiratory Membrane

Cross-sectional view of alveolar

walls and their vascular supply
 Diffusion of Gases Through
the Respiratory Membrane
 Respiratory Membrane layers :
 1. A layer of fluid lining the alveolus and containing
surfactant that reduces the surface tension of the
alveolar fluid
 2. The alveolar epithelium composed of thin epithelial
cells
 3. An epithelial basement membrane
 4. A thin interstitial space between the alveolar
epithelium and the capillary membrane
 5. A capillary basement membrane that in many
places fuses with the alveolar epithelial basement
membrane
 6. The capillary endothelial membrane
Diffusion of Gases Through
the Respiratory Membrane
 Factors That Affect the Rate
of Gas Diffusion Through the
Respiratory Membrane

 thickness of the membrane “edema ,

fibrosis”
 surface area of the membrane
“emphysema , total lung removal”
 diffusion coefficient of the gas in the
substance of the membrane
 partial pressure difference of the gas
between the two sides of the
membrane
 Effect of the Ventilation-
Perfusion Ratio on Alveolar
Gas Concentration
 ratio of alveolar ventilation to pulmonary
perfusion
 Alveolar ventilation ( 4l/min) / pulmonary blood
flow (5 L/min) = 0.8 normal ratio
 When the ventilation (Va) is zero, yet there is still
perfusion (Q) of the alveolus, the Va/Q. is zero.
 when there is adequate ventilation (Va) but
zero perfusion(Q.), the ratio Va/Q. is infinity.
 At a ratio of either zero or infinity, there is
no exchange of gases.
 Alveolar Oxygen and Carbon Dioxide Partial
Pressures When VA/Q
Equals Zero

 Va/Q= zero —that is, blood flow but

no alveolar ventilation —the air in the
alveolus comes to equilibrium with
the blood oxygen and carbon dioxide
because these gases diffuse between
the blood and the alveolar air
 Po2 = 40 mm Hg and a Pco2 = 45
mm Hg (same as venous blood)
 Alveolar Oxygen and Carbon Dioxide Partial
Pressures When VA/Q
Equals Infinity

 the alveolar air becomes equal to the

humidified inspired air. That is, the air
that is inspired loses no oxygen to the
blood and gains no carbon dioxide from
the blood. And because normal inspired
and humidified air has a Po2 of 149 mm
Hg and a Pco2 of 0 mm Hg, these will be
the partial pressures of these two gases of
the alveoli.
Gas Exchange and Alveolar Partial Pressures
When
VA/Q
Is Normal
 exchange of oxygen and carbon
dioxide through the respiratory
membrane is nearly optimal.
 Po2 is normally at a level of 104 mm
Hg
 alveolar Pco2 is normally 40 mm Hg
Normal PO2-PCO2, VA/Q
Diagram
 Concept of “Physiologic Shunt”
(When VA/Q is Below Normal)
 The total quantitative amount of shunted blood per
minute is called the physiologic shunt.

 a certain fraction of the venous blood passing through

the pulmonary capillaries does not become
oxygenated. This fraction is called shuntedblood.
Also, some additional blood flows through bronchial
vessels rather than through alveolar capillaries,
normally about 2 per cent of the cardiac output; this,
too, is unoxygenated shunted blood.
 Concept of the “Physiologic Dead
space”
(When VA/Q Is Greater Than Normal)
 there is far more available oxygen in the
alveoli than can be transported away from
the alveoli by the flowing blood. Thus, the
ventilation of these alveoli is said to be
wasted.
 The ventilation of the anatomical dead
space areas of the respiratory
passageways is also wasted.
 The sum of these two types of wasted
ventilation is called the physiologic dead
space
 O2 Transport
O2 is carried in blood in two forms
 (I) 97 % of the oxygen transported from the
lungs to the tissues is carried in chemical
combination with hemoglobin
 (II) 3% is transported in the dissolved
state in the water of the plasma and blood
cells
 Dissolved O2
 The amount of dissolved O2 is
directly proportional to PO2 (Henry’s
law)
 Amount of dissolved O2= PO2 X
0.003 ml O2/dl blood
 solubility coefficient for O2 (At 37oC,
each mm Hg PO2 results in0.003 ml
O2 dissolved in 100 ml of blood)
O2 bound to Hb
 α β
O2 bound to Hb
1

1
β 2 α 2

Hemoglobin molecule
tetramer, 2α /2β
Hb + O2 HbO2
DEOXYHAEMOGLOBIN OXYHAEMOGLOBIN

 Each Hb molecule can bind maximally with 4 O2

molecules
 When Hb is 100% saturated with O2, 1g Hb binds 1.34
ml O2
 The maximum amount of O2 that can be bound to Hb
per volume of blood (ie. when all the Hb present in a
volume of blood are fully saturated with O2) is known
as the oxygen carrying capacity of blood / O2-binding
capacity of blood / O2 capacity of blood = [Hb] x 1.34
 eg,. If [Hb] is 10g/dl, the O2 carrying capacity of blood
is 13.4 ml O2 /dl of blood or 134 ml O2 / litre of blood
 Arterial blood O2 content (CaO2) (mlO2/dl
blood)
= (amount of O2 bound to Hb) +
(dissolvedO2)
= ([Hb] x 1.34 x % Hb saturation) + (PO2 x
0.003)
In normal adult male at rest: PaO2 100
mmHg, [Hb] is 15g/dl
CaO2= (15 x 1.34 x 97/100) + (100 x 0.003)
= 19.8 ml O2/100 ml blood
 OXYGEN- HEMOGLOBIN
DISSOCIATION CURVE
 The total amount of Oxygen
carried by Hb in blood depends
upon:
 The percentage saturation of Hb.
 The amount of Hb in the blood.

 The quantitative relation between

the PO2 and Hb saturation is
called as the O2 – Hb dissociation
curve.(ODC)
OXYGEN DISSOCIATION
CURVE
 OXYGEN DISSOCIATION
CURVE
 Is sigmoid in shape due to Heme-
Heme interaction
 Oxygen linking occurs sequentially
for each subunit.
 Each combination facilitates the
next.(Cooperativity)
 SOME FEATURES OF THE
ODC
 P50  ODC SHIFTS:
 STR: Right:
 The partial pressure
  [H+]
of Oxygen at which   PCO2
50% saturation of   Temperature
Hb occurs. It is an   2,3 DPG.
index of the Hb  STL: Left:
affinity to Oxygen.   PCO2
 High P50 : Low   [H+]
affinity   Temperature
 2,3 DPG
Low P50 : High


affinity (Eg Fetal
Hb)
ODC: SHIFTS
 BOHR EFFECT
 Increased CO2 helps to release
more Oxygen from the
Hemoglobin.
 How?
 By altering the configuration and
decreasing the Oxygen affinity.
 Is useful during physical exercise
when more of Carbon dioxide is
produced.
 FETAL
HEMOGLOBIN
 It has no Beta chain.
 It has more affinity to
Oxygen than the Adult
Hemoglobin.
 This helps the fetus to
extract Oxygen from the
maternal blood.
 Advantages of “S-shaped” curve for Hb-O2 association
20

High affinity only

Can’t release much
O2 to tissues

15 S-shaped hemoglobin curve

Releases much Becomes saturated
ml O2/100 ml blood

O2 at tissues with O2 at lungs

10

Low affinity only

Doesn’t hold on to But can’t pick up
much O2 at tissues much O2 at lungs
5

Active cell
 CO2 transport

 7% in plasma
 23% in plasma
7%
carbamino 23%
compounds Carbmino
Hb
(bound to globin 70% Bicarbona
te
part of Hb)
 70% as
Bicarbonate
 CARBONDIOXIDE IN PLASMA

 If the PCO2 increases, more CO2

dissolves and the concentrations of H+
& HCO3 increase.
 On the other hand, if the [H+] & [HCO3]
levels rise, the CO2 will rise.
 The dissolved CO2 will be given out as
gas.
 So, [H2CO3]  [H+] + [HCO3-]
 CARBONDIOXIDE IN PLASMA
 CO2 is more soluble than O2 in water.
 CO2 unlike O2 reacts with water.
 CO2 + H2O  H2 CO3 (Carbonic Acid)
 Carbonic Acid dissociates to Hydrogen &
Bicarbonate ions.
 H2 CO3  H+ + HCO3-
CARBON DIOXIDE IN BLOOD

 200 ml of CO2 is produced per minute

at rest.
 It diffuses from the tissues to the
blood.
 As it is more soluble, is more
dissolved in blood.
CARBON DIOXIDE IN BLOOD
 In physical solution
Plasma/Erythrocyte: 7%
 As Carbamino Hemoglobin : 23%
 CO2 + Hb  HbCO2
 As Bicarbonate ions: 70%
 Mostly in the Erythrocyte which has the
enzyme, Carbonic anhydrase .(Catalyses the
formation of Carbonic acid 5000 times.)
 CO2 + H2O  H2 CO3 [H+] + [HCO3-]
 CHLORIDE SHIFT
 Most of the HCO3- so formed in the
Erythrocyte, shifts out through a
transporter.
 This is an antiport which influxes one
ion of Chloride for every ion of
Bicarbonate shifting out.
 This is called as the Chloride shift or
the Hamburger Phenomenon/shift.
 HAMBURGER EFFECT
 The Chloride shift occurs in the tissue
capillaries.
 Since some bicarbonate and Cl-
remain and the osmolarity of RBCs
increases, they swell slightly.
 This is called “Hamburger effect.”
Tissues

Carriage of CO2 is almost entirely a

simple chemical and physical set of
reactions (capable of occurring in
any aqueous solution), except for
speed of reaction.

Lungs
 HALDANE EFFECT
 Is opposite to the Bohr effect.
 Binding of Oxygen to Hemoglobin
tends to displace CO2 from the blood.
 This is called as the Haldane effect.
 Is quantitatively more important than
the Bohr effect.
 It promotes the transfer of CO2
 EFFECTS OF CO
 CO binds to Hb on its Oxygen binding
sites.
 It has about 200 times the affinity of
Oxygen for Hb.
 So it excludes Oxygen from binding
to Hb.
 The Oxygen carrying capacity of
blood is reduced.
CO Poisoning: symptoms
HEADACHE CHERRY PINK CHEEKS
 CO Poisoning: Therapy
 High concentrations of Oxygen are given
to occupy all available sites on Hb &
cause CO dissociation.
 Administration of some CO2 will:
 stimulate ventilation
 cause a STR of the ODC

 Improve perfusion of certain organs.

 Carbogen: Has 5% CO2 in O2

 CO Poisoning: Therapy

 Hyperbaric
Hyperbaric O2 O2

 O2
O2 at
at aa level
level higher
higher than
than
atmospheric
atmospheric pressure
pressure
 Increase
 Increase po2
po2 inin tissues
tissues
increase
increase oxygen
oxygen transport
transport
capacity
capacity of
of the
the blood
blood by
by
increasing
increasing O2O2 transport
transport byby
plasma
plasma