Effect of increased intracranial pressure on blood pressure, heart rate, respiration and catecholamine levels in neonatal and adult rabbits.

The effect of increased intracranial pressure (ICP) on heart rate, respiratory rate and blood pressure was measured in 2-day-old and adult rabbits. Neonates and adults exhibited the Cushing reflex with hypertension, bradycardia and decreased respirations when exposed to elevated ICP. Adult animals had a lower threshold of response to elevated ICP, implying a more sensitive adrenergic response compared to neonates. Although control levels of epinephrine and norepinephrine were higher in neonates compared to adults, the ratio of maximum concentration during increased ICP to control concentration was higher in adults (27.0 for epinephrine and 25.2 for norepinephrine in adults: 3.5 for epinephrine and 2.93 for norepinephrine in neonates). Injection of epinephrine was used to induce a maximal sympathetic response in both groups of rabbits studied. In adults, the cardiovascular response was the same after injection of epinephrine or after increasing ICP. In neonates, the blood pressure rise after injection of epinephrine was significantly higher (p less than 0.05) than the blood pressure rise after increasing ICP. The results demonstrate an immature adrenomedullary axis in neonates who have higher resting levels of catecholamines with a relatively smaller increase in catecholamines in response to stress when compared to adults.