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J Appl Physiol 87: 862-866, 1999;
8750-7587/99 $5.00
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Vol. 87, Issue 2, 862-866, August 1999

SPECIAL COMMUNICATION
Quantitative assessment of changes in blood CO2 tension mediated by the Haldane effect

Ivo Giovannini1,2, Carlo Chiarla2, Giuseppe Boldrini1,2, and Renato Terzi3

1 Department of Surgery (Geriatric Surgery) and 2 Consiglio Nazionale delle Ricerche Center for the Study of Pathophysiology of Shock, Catholic University School of Medicine, I-00168 Rome, Italy; and 3 Intensive Care Unit, Hospital das Clinicas, University of Campinas School of Medicine, 13100 Campinas, SP, Brazil

Adequate assessment of circulatory and gas-exchange interactions may involve the quantification of the Haldane effect (HE) and of the changes in blood PCO2 mediated by changes in Hb-O2 saturation and O2-linked CO2 binding. This is commonly prevented by the complexity of the involved calculations. To simplify the task, a large series of patient measurements has been processed by regression analysis, thus developing an accurate fit for this quantification
(v-a) P<SC>co</SC><SUB>2 HE</SUB> = 0.460 [(a-v) HbO<SUB>2</SUB>)]<SUP>0.999</SUP><IT>e</IT><SUP>0.015(Pv<SUB>CO<SUB>2</SUB></SUB>)−0.852(Hct)</SUP>
(n = 247, r2 = 0.99, P << 0.001), where (v-a)PCO2 HE is the reduction in venous PCO2 (PvCO2, Torr) allowed by the chemical binding of CO2 in blood due to the HE (Torr), (a-v)HbO2 is the arteriovenous difference in Hb-bound O2 (ml/dl), and Hct is hematocrit fraction. Values of (v-a)PCO2 HE estimated by this expression compared well with the results of previously published experiments. This formula is useful in assessing the impact of HE on PvCO2 and venoarterial PCO2 gradient and the survival advantage offered by HE in extreme conditions. Use may be extended to all investigative and clinical settings in which changes in blood O2 saturation and O2-linked CO2 binding must be converted into the corresponding changes in dissolved CO2 and PCO2.

carbon dioxide exchange; circulatory failure; respiratory failure; shock; venous hypercapnia; sepsis


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