Biomedical Laboratory Science

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Respiring cells produce CO2 at the rate of 200 ml/minute. As CO2 increases in the tissues it goes down its concentration gradient into the plasma and into the erythrocyte.

Most of the CO2 is converted to bicarbonate and H+ by carbonic anhydrase in the erythrocytes. This conversion of CO2 maintains a pressure gradient favoring diffusion of CO2 from the tissue into the blood. As bicarbonate levels in the erythrocyte increase, bicarbonate ions are transported out of the erythrocyte in exchange for Cl- . This coupled exchange of HCO3- for Cl- is referred to as the chloride shift. The H+ left behind in the erythrocyte is buffered by binding to hemoglobin.


In the lungs, the pressure gradient favors the diffusion of CO2 from the blood into the alveoli. The decrease in CO2 causes bicarbonate in the erythrocyte to bind with H+ to form carbonic acid which in turn is converted into CO2 and H2O by carbonic anhydrase. While bicarbonate in the erythrocyte decreases more bicarbonate is brought into the erythrocyte in exchange for Cl- .

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