A platform for near real-time and multiplexed monitoring of cerebrospinal fluid biomarkers and flow in neurocritical care

Real-time monitoring of cerebrospinal fluid (CSF) is critical in intensive care units for the timely management of complications such as infection and mechanical malfunction in patients with external ventricular drainage systems. Current practice relies on intermittent CSF sampling for laboratory-based biomarker analysis and manual inspection, resulting in delayed reporting and intervention. To address these limitations, we developed NeuroSense, a multiplexed sensing platform that integrates with standard external ventricular drainage systems to enable near real-time monitoring of key CSF (bio)markers, including glucose, lactate, pH, and flow rate, that are essential for detecting infection and drain dysfunction. NeuroSense incorporates glucose and lactate aptamer-based electrochemical biosensors, a polydopamine pH sensor, and an impedance-based flow sensor. Validation in simulated conditions demonstrated sensor specificity, stability in human CSF for several days, and ethylene-oxide sterilization compatibility. Evaluation in patients hospitalized in intensive care unit demonstrated strong correlation with clinical reference standards. By providing near real-time bedside assessment, NeuroSense has the potential to improve temporal resolution for detection of biomarker trends and drain malfunction indicators.