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Chloride shift

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Carbon dioxide is produced by the tissues and diffuses into the plasma. In the plasma:

  • a small proportion becomes bound to plasma proteins forming carbamino compounds

  • a small proportion reacts slowly to form carbonic acid which dissociates to form a hydrogen ion and bicarbonate

  • largest proportion enters the red cell where it rapidly forms carbonic acid:
    • this reaction is catalysed by carbonic anhydrase
    • within the red cell, the carbonic acid dissociates and the hydrogen ion combines with the reduced haemoglobin and the bicarbonate diffuses out of the cell
    • the loss of anionic bicarbonate from the cell is compensated (maintaining electrical neutrality) by an influx of chloride ions (anions) - the so-called 'chloride shift'

  • 5-10% of carbon dioxide is transported via direct binding of carbon dioxide to haemoglobin (carbaminohaemoglobin)
    • production of this compound is increased in conditions of hypoxia and reduced when the haemoglobin is oxygenated

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