Summary: An international research team has developed a near real-time clinical monitoring platform designed to eliminate diagnostic delays and lower costs in brain‑injury care. Called NeuroSense, the system connects directly to external brain drainage lines to continuously assess cerebrospinal fluid (CSF) for early signs of infection and drain malfunction.
By continuously measuring key biochemical markers and flow metrics at the bedside, NeuroSense bypasses the slow, intermittent laboratory testing that can delay treatment. The platform aims to detect dangerous ICU infections and mechanical failures early enough to prevent lasting neurological damage and reduce extended hospital stays.
Key Facts
- The Drainage Infection Crisis: In the United States, roughly 25,000 patients annually require external drains for conditions such as traumatic brain injury, hydrocephalus, or brain hemorrhage.
- The Toll of Delayed Detection: Up to 20% of these cranial drainage cases develop infections, which frequently more than double hospital length of stay and raise the risk of severe complications such as meningitis, neurological impairment, disability, and death.
- The Standard Laboratory Bottleneck: Current clinical practice depends on manual CSF sampling and laboratory analysis, typically performed only once every 24 to 48 hours, which can delay diagnosis and treatment decisions.
- The NeuroSense Architecture: NeuroSense integrates with standard external ventricular drainage systems to monitor vital CSF biomarkers—glucose, lactate, and pH—plus fluid flow rate in near real time.
- Bedside Micro‑Sensor Hardware: The system uses a compact, 3D‑printed unit approximately the size of a smartphone. It houses four dedicated sensors, an electrochemical analyzer, and a live display for continuous bedside readouts.
- Global Academic Alliance: The project, led at Waterloo by Dr. Mahla Poudineh and PhD student Fatemeh Keyvani, brings together researchers from the University of Waterloo, University Medicine Rostock, MIT, and Harvard Medical School.
- The Commercialization Roadmap: After promising initial validation and limited patient testing, the team plans to add automated clinician alerts, expand clinical trials, and refine components ahead of potential commercialization.
Source: University of Waterloo
A research group led by the University of Waterloo has developed a bedside monitoring system intended to save lives and reduce health‑care costs by enabling much earlier detection of infections and drain problems in neurocritical care.
“This platform is designed to capture trends almost immediately and identify complications before they escalate,” said Dr. Mahla Poudineh, professor of electrical and computer engineering and Canada Research Chair in Health Monitoring BioNano Devices at Waterloo.
In the U.S. alone, about 25,000 patients each year require drains to remove excess CSF following traumatic brain injury, hydrocephalus, or brain hemorrhage. Because drains provide a direct pathway into the central nervous system, infections are a frequent and severe complication.
Up to one in five patients with external drainage develop infections that commonly double hospitalization time and can lead to serious outcomes including meningitis and permanent neural injury. Clinicians typically rely on periodic CSF sampling sent to centralized labs, a labor‑intensive workflow that only yields results every 24–48 hours.
Recognizing that improved temporal resolution could meaningfully change patient care, the international research team developed NeuroSense to continuously monitor CSF chemistry and flow. The device detects metabolic shifts such as falling glucose or rising lactate, changes in pH, and alterations in flow rate—signals that can indicate infection or drain obstruction.
The compact 3D‑printed module contains four sensors linked to an electrochemical analyzer and an on‑device display, enabling clinicians and bedside staff to view live biomarker trends without waiting for lab returns. In early tests, NeuroSense showed strong agreement with standard reference methods and performed successfully with a small number of intensive care patients.
“The main advantages are earlier warning of infection or drain malfunction and faster, better-informed treatment choices,” said Fatemeh Keyvani, a PhD student in electrical and computer engineering at Waterloo who spearheaded the work.
Next steps include integrating an automated alarm to alert clinicians when readings cross actionable thresholds, conducting larger clinical studies to confirm performance, and refining the system’s components as the team advances toward commercialization.
Collaborators on the project include researchers at University Medicine Rostock, the Massachusetts Institute of Technology, and Harvard Medical School, in addition to the University of Waterloo team.
Key Questions Answered:
A: External drains create a direct pathway into the brain and spinal fluid. When drains are inserted to relieve intracranial pressure after hemorrhage or trauma, they also increase the risk of infection; up to 20% of these patients develop infections that significantly prolong hospitalization.
A: NeuroSense effectively turns the drainage line into a live diagnostic channel. Instead of periodic manual sampling and delayed lab analysis, the platform continuously reads chemical and flow signals as CSF moves through the tube, providing immediate bedside information.
A: The device monitors a four-part biomarker profile: glucose, lactate, pH, and flow rate. Rapid or sustained changes in these measures can indicate an infectious response or mechanical dysfunction of the drain.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full.
- Additional context was added by editorial staff.
About this neuroscience and neurotech research news
Author: Ryon Jones
Source: University of Waterloo
Contact: Ryon Jones – University of Waterloo
Image: The image is credited to Neuroscience News
Original Research: Closed access. “A platform for near real-time and multiplexed monitoring of cerebrospinal fluid biomarkers and flow in neurocritical care” by Fatemeh Keyvani, Luisa M. Muller, Natalie Fudge, Bridget MacLean, Agosh Saini, Joshua Khatri, Thomas Kriesen, Matthias Wittstock, Florian A. Gessler, Robert Langer, Joshua D. Bernstock, Shriya Srinivasan, and Mahla Poudineh. Science Translational Medicine
DOI: 10.1126/scitranslmed.aeb1381
Abstract
A platform for near real-time and multiplexed monitoring of cerebrospinal fluid biomarkers and flow in neurocritical care
Real‑time monitoring of cerebrospinal fluid is crucial in intensive care for timely detection and management of complications such as infection and mechanical malfunction in patients who rely on external ventricular drainage systems. Existing practice depends on intermittent CSF sampling and laboratory biomarker analysis, which delays reporting and clinical intervention.
To overcome these limitations, the research team developed NeuroSense, a multiplexed sensing platform that integrates with standard external ventricular drainage systems to deliver near real‑time monitoring of key CSF indicators: glucose, lactate, pH, and flow rate. These measures are important for detecting infection and identifying drain dysfunction early.
NeuroSense combines aptamer‑based electrochemical biosensors for glucose and lactate, a polydopamine pH sensor, and an impedance‑based flow sensor. Validation in laboratory simulations showed sensor specificity, stability in human CSF over days, and compatibility with ethylene‑oxide sterilization.
Evaluation in a small group of intensive care patients demonstrated strong correlation with standard clinical reference methods. By providing near real‑time bedside assessment, NeuroSense can improve the temporal resolution available to clinicians for detecting biomarker trends and signs of drain malfunction.