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Respiration
Published in Sarah Armstrong, Barry Clifton, Lionel Davis, Primary FRCA in a Box, 2019
Sarah Armstrong, Barry Clifton, Lionel Davis
The Haldane effect is the increased ability of the blood to carry CO2 when haemoglobin gives up its O2 (deoxyhaemoglobin is three times more effective at forming carbamino compounds than oxyhaemoglobin)
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Binding of oxygen with haemoglobin tends to displace carbon dioxide from the blood; this is known as the Haldane effect. In the capillaries, the Haldane effect causes increased pick up of CO2 because of O2 removed from the haemoglobin, while in the lungs it causes increased release of CO2 because of O2 pick up by the haemoglobin.
Placental Transfer
Published in Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod, The Primary FRCA Structured Oral Examination Study Guide 1, 2017
Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod
The Haldane effect describes the increased affinity of deoxygenated haemoglobin for CO2 and vice versa. This is relevant across the placenta because as the fetus gives up CO2 it increases its affinity for O2, and as the mother gives up her O2 her haemoglobin has an increased affinity for the CO2. This is called the ‘double Haldane effect’.
Hypoxemia and not hyperoxemia predicts worse outcome in severe COPD exacerbations - an observational study
Published in European Clinical Respiratory Journal, 2023
Charlotte Sandau, Ejvind Frausing Hansen, Lars Pedersen, Jens Ulrik Stæhr Jensen
Furthermore, gas exchange in the lungs is complex with hypoxemia, hypercapnia and acidosis influenced by a number of processes such as hypoxic pulmonary vasoconstriction, increased ventilation/perfusion-mismatch, the Haldane effect, resorption atelectasis, and inhibition of hypoxic drive, making therapy is equally complex [28]. It is known that hypercapnia and/or acidosis develops at a slower rate than hypoxemia. Despite this, literature indicates that between 10–20% of AECOPD admitted in hospitals present with type 2 respiratory failure by arrival [29,30], these patients are not included in our study, making it hard to compare our risk estimates with previous literature. However, it has been shown, that patients who develop acidosis during admission and initiate NIV after 24 hours of admission, have a higher mortality rate than those who arrive at the hospital with acidosis [31,32]. These patients, susceptible for hypercapnia and known for their need of close monitoring, are presented in our data. However, the high rate of hyperoxemic episodes reported in our study is associated with a relatively low risk of hypercapnia. This indicates that the complex clinical procedure of monitoring oxygen administration via observations, algorithms, and Arteria Blood Gas (ABG) values have better conditions in hospital settings as opposed to pre-hospital settings and stress the importance of it.