Summary: An international research team developed a bedside monitoring platform to reduce delayed diagnoses and lower healthcare costs for patients with brain injuries. Called NeuroSense, the system integrates directly with external cerebrospinal fluid (CSF) drainage lines to provide near real-time detection of biochemical changes and flow problems that can signal infection or device malfunction.
By continuously analyzing CSF for critical biomarkers and measuring flow, NeuroSense avoids the time lag of traditional laboratory testing. The device is designed to alert clinical teams earlier to life-threatening infections and drainage failures, enabling faster intervention and potentially preventing permanent neurological harm.
Key Facts
- The drainage infection burden: In the United States each year, roughly 25,000 patients with traumatic brain injury, hydrocephalus, or brain hemorrhage require external drains to remove excess CSF.
- Consequences of delayed diagnosis: Up to 20% of these drainage cases develop infections that significantly prolong hospital stays and increase the risk of severe complications such as meningitis, neurological damage, disability, and death.
- Limitations of current practice: Standard care relies on periodic sampling of CSF and laboratory analysis, a manual process typically performed every 24–48 hours that can miss rapid changes and delay treatment decisions.
- NeuroSense design: The platform connects directly to existing external ventricular drainage systems and continuously monitors four critical parameters: glucose, lactate, pH, and flow rate.
- Compact bedside hardware: A 3D‑printed, smartphone-sized module houses four specialized electrochemical sensors, an analyzer, and a live display so clinical staff can view trends at the bedside.
- Collaborative research network: The project is led by Dr. Mahla Poudineh and PhD student Fatemeh Keyvani at the University of Waterloo and includes collaborators from University Medicine Rostock, MIT, and Harvard Medical School.
- Path toward clinical use: After initial validation, the team plans to add automated clinician alerts, expand clinical testing, refine the device, and pursue steps required for larger trials and potential commercialization.
Source: University of Waterloo
Overview
A multidisciplinary team led by the University of Waterloo has created NeuroSense, a bedside monitoring system intended to improve outcomes and reduce costs for neurocritical care patients by detecting infections and drainage problems earlier than current methods allow. The platform is built to capture biochemical trends in CSF continuously, providing clinicians with more timely information to guide urgent treatment.
External ventricular drains and other CSF drainage devices are lifesaving but create an entry route for pathogens. Recognizing that intermittent laboratory testing is slow and labor-intensive, the team designed NeuroSense to function as a continuous diagnostic extension of the drainage line. The system records trends in glucose, lactate and pH—biomarkers that shift during infection—as well as the mechanical flow rate, which can indicate clogging or disconnection.
The hardware is a portable, 3D‑printed unit about the size of a smartphone. Inside are electrochemical biosensors—two based on aptamer recognition for glucose and lactate—along with a polydopamine pH sensor and an impedance-based flow sensor. An on-board analyzer interprets signals and displays live values and trends for the clinical team.
Initial validation included bench testing in simulated CSF, compatibility with sterilization methods, stability measurements over several days, and a small patient evaluation in an intensive care unit. The device showed strong correlation with laboratory reference standards and demonstrated specificity and stability suitable for further clinical study.
The researchers emphasize that continuous bedside monitoring could shorten the time to detect infection or drain malfunction, enabling earlier, evidence-based treatment decisions and potentially lowering the morbidity, length of stay, and costs associated with delayed intervention.
Key Questions Answered:
A: External drains inserted to relieve intracranial pressure provide a direct route into the central nervous system. When drains remain in place, the risk of infection rises; such infections occur in roughly one in five drainage cases and can substantially extend hospital stays and worsen outcomes.
A: NeuroSense attaches to the drainage line and continuously measures chemical and flow markers as CSF passes through. This in-line monitoring eliminates the need for frequent manual sampling and long turnaround times for laboratory analysis, delivering near real-time information at the bedside.
A: The system tracks a four-part profile—glucose, lactate, pH, and flow rate. Acute or sustained deviations in these parameters can indicate an inflammatory or infectious process or signal mechanical problems with the drain.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by the editorial team.
- Additional context was added by staff to explain clinical implications.
About this neuroscience and neurotech research news
Author: Ryon Jones
Source: University of Waterloo
Contact: Ryon Jones – University of Waterloo
Image credit: 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
Timely, continuous monitoring of cerebrospinal fluid (CSF) is essential in neurocritical care to detect complications such as infection and mechanical malfunction in patients with external ventricular drainage systems. Current practice depends on intermittent CSF sampling and laboratory-based biomarker analysis, which results in delayed reporting and slower clinical responses.
To overcome these limitations, NeuroSense was developed as a multiplexed sensing platform that integrates with standard external ventricular drainage systems to provide near real-time assessment of key CSF biomarkers—glucose, lactate, and pH—together with flow rate measurements. The platform combines aptamer-based electrochemical biosensors for glucose and lactate, a polydopamine pH sensor, and an impedance-based flow sensor.
Validation under simulated conditions showed sensor specificity, stability in human CSF for several days, and compatibility with ethylene-oxide sterilization. Early clinical evaluation in intensive care patients found strong correlation with clinical reference standards. By delivering near real-time bedside data, NeuroSense has the potential to improve the temporal resolution of biomarker trend detection and to provide earlier indication of drain malfunction, supporting faster, more informed clinical decision-making.