There are three means by which carbon dioxide is transported in the bloodstream from peripheral tissues and back to the lungs:
- dissolved gas,
- bicarbonate, and
- carbaminohemoglobin bound to hemoglobin (and other proteins).
As carbon dioxide diffuses into the bloodstream from peripheral tissues, approximately 10% of it remains dissolved either in plasma or the blood's extracellular fluid matrix, to a partial pressure of about 45 mmHg.[2] Most of the carbon dioxide diffusing through the capillaries and ultimately into the red blood cells combines with water via a chemical reaction catalyzed by the enzyme carbonic anhydrase catalyzes, forming carbonic acid. Carbonic acid almost immediately dissociates into a bicarbonate anion (HCO3-) and a proton. Thus, bicarbonate is the primary means by which carbon dioxide is transport occurs throughout the bloodstream according to the equation
CO2 + H2O --> H2CO3 --> H+ + HCO3-.