Hemoglobin saturation levels

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rwe

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When diving with either air or Nitrox the blood fluid will increase its oxygen concentration according to Henry's Law. However, this oxygen is a small fraction of the oxygen carried by the hemoglobin. How much extra oxygen is carried by the hemoglobin when breathing higher oxygen partial pressures? I.e., with air at the surface, is the hemoglobin (in blood leaving the lungs) near its maximum carrying capacity or is its carrying capacity significantly increased with increased oxygen partial pressures?
 
Hemoglobin leaving the lungs is generally near saturation (even at standard pressures)

The environment of the lungs increases the affinity of hemoglobin for oxygen via a basic biochemical mechanism known as allostery. Essentially this means that factors in the lungs causes changes in the shape of the hemoglobin molecule that ultimately result in increased "tightness" of its binding to oxygen.

Essentially, these factors are higher pH (relative to the tissue bed and secondary to lower pCO2), cooler temperature, and lower levels of a cellular metabolite called 2,3-bis-phosphoglycerate. These characteristics are generally the inverse in the capillary beds resulting in decreased affinity of hemoglobin for oxygen (afterall, the oxygen wouldn't be very useful if the hemoglobin never let go of it so your cells can take it in).

Hemoglobin also exhibits "sigmoidal" kinetics with regard to oxygen binding. Hemoglobin exists as a tetramer, meaning it is four polypeptide (or protein) molecules bound togeather by non-covalent means (stuck togeather like magnets...not permanently). Once one oxygen molecule binds to one chain of the tetramer, the affinity of the tetramer for oxygen increases, again through an allosteric mechanism. This affinity increases even more as oxygen molecules successively bind, until the tetramer is saturated by 4 molecules of O2 and can bind no more.

Thus, any sample of blood will contain hemoglobin molecules that are completely saturated and those that are not. There will exist very few molecules bound to 1,2, or 3 oxygens (the majority either have 4 or 0). This is of course because the higher affinity molecules that are already partially oxygen bound, "steal" the oxygens from the less tightly bound molecules.
 
So at standard pressure if the hemoglobin is > 95% saturated leaving the lungs (a guess from your note) and the fluid contains ~ 6 ppm oxygen (a guess based on lake water oxygen levels), what fraction of the total oxygen is being carried as the oxygen dissolved in the fluid? If I am breathing Nitrox at 1.4 atm oxygen partial pressure and the fluid oxygen increases to ~ 42 ppm is it enough to be a significant fraction of the total oxygen in the blood?
 
It is not significant. I cannot remember the precise figures, but even when we ventilate patients on 100% O2, the dissolved oxygen is a very small proportion of the total oxygen content in the blood. Without hemoglobin, we do not do well.
 
Inhaling 100% O2 I would estimate the total dissolved oxygen in plasma to be about 1 liter, exclusive of any metabolic processes.
 
If you consider all the oxygen in the blood, about 96% of the total amount is bound to hemoglobin while about 4% is dissolved. Because of this huge difference in the amount bound vs. dissolved classical physiology says that the bound part is much more important, but I don't really believe that's true. If you think about it, in order for oxygen to get into cells it must be dissolved. it has to come off the hemoglobin and dissolve into the liquid part of the blood (called plasma) before it can go anywhere, so the dissolved oxygen is the part that is available for immediate use, and the hemoglobin-bound oxygen is like a supply depot to replenish the dissolved oxygen as it gets used up.

A couple of examples illustrate this really nicely. if people are put in a situation where they are breathing 10% O2, the amount of oxygen bound to hemoglobin doesn't drop off all that much, so your blood oxygen content stays at about 75% of normal, but the dissolved part decreases dramatically, and you die. On the other hand one of the things we do in the operating room for cardiac cases all the time is to remove a portion of the patient's blood and replace it with a saline solution. We can dilute the hemoglobin concentration from a normal value of 14 mg/dL down to 8 mg/dL which results in your blood oxygen content dropping to about 54% of normal because the amount bound to hemoglobin is basically cut in half, but the amount dissolved in the plasma is normal, and these patients do just fine.

It's not as simple as physiologists once believed.

Cam Smith, PhD
 
Hi rwe:

At about 3 ATM (100% oxygen), all of the oxygen needed needed for the body is dissolved in the plasma (liquid portion) of the blood. You could "breathe" in a hyperbaric chamber without any red blood cells.
 

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