title: Are serum nitric oxide and vascular endothelial growth factor levels affected by packed red blood cell transfusions?
abstract: BACKGROUND
  Nitric oxide (NO) and vascular endothelial growth factor (VEGF) are important mediators for hemodynamics and angiogenesis in the body. NO coming from endothelial cells and red blood cells is particularly effective in hypoxic vasodilation. VEGF has known effects on the induction of NO synthesis and is also known to be affected by blood product transfusions. The objectives of this study were to measure NO and VEGF levels before and after packed red blood cell (PRBC) transfusions.
  
  
  METHODS
  Blood was drawn from preterm newborns before and 30 min after PRBC transfusions and samples were used for NO and VEGF measurements. NO end products nitrite and nitrate were measured by modified Greiss method, VEGF levels measured by double sandwitch ELISA method. Vital signs including heart rate and blood pressure were also recorded.
  
  
  RESULTS
  Thirty four newborns were included in the study and overall 54 transfusion episodes were assessed for mediator levels. No difference was observed between the mediator levels before and after PRBC transfusions. Vital signs were also unchanged.
  
  
  CONCLUSIONS
  As there was no change in NO end product levels with PRBC transfusions, it might suggest that hypoxia was not severe enough to cause nitrite increase; however, other NO sources might still be active. VEGF levels were found to be unchanged and may reflect a delayed effect of transfusion on VEGF induction.
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Gazi University Hospital, Ankara, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ergenekon
authors.forename: Davut
authors.initials: D
authors.lastname: Bozkaya
authors.forename: Tayfun
authors.initials: T
authors.lastname: Goktas
authors.forename: Deniz
authors.initials: D
authors.lastname: Erbas
authors.forename: Aysegul
authors.initials: A
authors.lastname: Yucel
authors.forename: Ozden
authors.initials: O
authors.lastname: Turan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Hirfanoglu
authors.forename: Esra
authors.initials: E
authors.lastname: Onal
authors.forename: Canan
authors.initials: C
authors.lastname: Turkyilmaz
authors.forename: Esin
authors.initials: E
authors.lastname: Koc
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Atalay
mesh_terms: D017707:Erythrocyte Transfusion; D006801:Humans; D000860:Hypoxia / Q000097:blood; D007231:Infant, Newborn / Q000097:blood*; D007234:Infant, Premature / Q000097:blood*; D009569:Nitric Oxide / Q000097:blood* / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055986:Vital Signs
chemical_list: D042461:Vascular Endothelial Growth Factor A; D009569:Nitric Oxide