“The colouring substance of blood”

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Over a century ago, Stokes wrote on the oxidation and reduction of “the colouring substance of the blood.” The mechanisms that govern the binding of oxygen to hemoglobin have been defined in even greater detail and higher orders of accuracy, even to the ends of the oxyhemoglobin dissociation curve. The Bohr effect has ceased to be a reduction in the affinity of hemoglobin for oxygen due to an increasing hydrogen ion concentration and according to a mere logarithmic equilibration constant. The constant has become a variable, subject to the interactions of temperature, carbon dioxide, organic phosphate, and ionic concentrations. This interdependence of so many variables has rendered the once inaccurate, but precise prediction of the effect of the reactants on oxyhemoglobin dissociation into a technological juggling act, well beyond the means of the average physician managing the treatment of a sick patient.

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