呼吸科呼吸系统3PPT.ppt

5.3. Gas transport Oxygen is transported by the blood in both physically dissolved and hemoglobin-bond forms. Carbon monoxide binds the same site on hemoglobin as oxygen does and is dangerous to life. Carbon dioxide (CO2) is transported in three forms: physically dissolved, bicarbonate, and carbaminohemoglobin * * Oxygen Transport in the Blood * * * * Hemoglobin (Hb) Each Hb molecule consists of four globular protein (globin, 珠蛋白) subunits. Each subunit is composed of a protein chain tightly associated with a non-protein heme（血红素） group. Oxygen binds to iron (Fe2+) on heme. Two Forms of Oxygen Exist in the Blood Physically dissolved: 2% Dissolved O2 (ml/dL) = 0.003 (ml/dL/mmHg) X Pa O2 (mmHg) Combined with Hb: 98% Both physically dissolved and chemically bond are important. Oxyhemoglobin (HbO2): Hemoglobin binds to oxygen. Deoxyhemoglobin (Hb): Hemoglobin that does not bind with oxygen. * * Oxygen Binds to Hemoglobin The binding of oxygen to hemoglobin is reversible and very quick. The reaction of this biding is oxygenation but not oxidation (ferrous remains as ferrous). Each hemoglobin molecule can bind four oxygen molecules. Each gram of hemoglobin can bind up 1.34~1.39 ml of O2 (depending on methemoglobin levels). * * Oxygen Dissociation Curve * * Analysis of Oxygen Dissociation Curve When PaO2 is increased from 60 and 100 mmHg, SaO2 rises only by 7%. The clinical significance of the flat portion of oxygen dissociation curve is that a drop PO2 from 100 to 60 mmHg still results in hemoglobin saturation of 90%. Rising PaO2 above 100 mmHg barely affects oxygen content. In the steep portion of this curve, blood oxygen content and thus oxygen delivery to tissues are compromised upon PO2 falls below 60 mmHg. The significance of this portion of the curve is that a large amount of O2 is released from hemoglobin with a small change in PO2. * * Changes in Blood Chemistry Alter Hemoglobin’s Affinity for O2 * * To remember Just think that an exercising muscle is