Physiology · Cardiac Physiology (Cycle, Output, ECG, Electrophysiology)

Which of the following changes shifts the oxygen–haemoglobin dissociation curve to the RIGHT, favouring oxygen unloading at the tissues?

  • A Decreased temperature
  • B Decreased PCO2
  • C Increased 2,3-bisphosphoglycerate (2,3-BPG)
  • D Increased pH (alkalosis)
Correct answer: C. Increased 2,3-bisphosphoglycerate (2,3-BPG)

Explanation

A rightward shift (decreased Hb–O2 affinity) is produced by increased 2,3-BPG, increased temperature, increased PCO2 and decreased pH (acidosis) — the conditions of metabolically active tissue (Bohr effect). Each of the other options shifts the curve to the left.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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