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Evaluation of a Novel Automated Cerebral Ventricular Drainage System for Intracranial Pressure Monitoring and Cerebrospinal Fluid Drainage in Neurocritical Care Patients : A Prospective, Randomized Clinical Study

Öhman, Josefine Maria LU ; Marklund, Niklas LU orcid and Cederberg, David LU (2026) In Neurocritical Care
Abstract

BACKGROUND: Neurointensive care is moving toward more automated patient management. This study aimed to evaluate a novel external ventricular drainage (EVD) system, the VGuard® system, as a tool for intracranial pressure (ICP) monitoring and automating ventricular drainage of cerebrospinal fluid (CSF), focusing on its safety and potential to reduce complications associated with manual EVD management.

METHODS: This prospective, randomized clinical study was conducted in the Department of Neurosurgery at Skåne University Hospital, Lund, Sweden. Patients (aged > 18 years) with different acute brain pathologies requiring an EVD were enrolled and randomized (1:1) to receive the VGuard® system or a manual EVD. Both systems employed a... (More)

BACKGROUND: Neurointensive care is moving toward more automated patient management. This study aimed to evaluate a novel external ventricular drainage (EVD) system, the VGuard® system, as a tool for intracranial pressure (ICP) monitoring and automating ventricular drainage of cerebrospinal fluid (CSF), focusing on its safety and potential to reduce complications associated with manual EVD management.

METHODS: This prospective, randomized clinical study was conducted in the Department of Neurosurgery at Skåne University Hospital, Lund, Sweden. Patients (aged > 18 years) with different acute brain pathologies requiring an EVD were enrolled and randomized (1:1) to receive the VGuard® system or a manual EVD. Both systems employed a ventricular probe for simultaneous intraventricular and intraparenchymal ICP monitoring. Measurement accuracy was determined by comparing the median of absolute difference in ICP, using the Mann-Whitney U test. To further investigate the accuracy of ICP measuring, a post hoc Spearman correlation test was applied. In addition, as part of a post hoc analysis, we evaluated patient outcomes.

RESULTS: A total of 30 patients were included in the study. The VGuard® system demonstrated significantly better accuracy in ICP measurements compared with the manual EVD; median absolute difference: 1.07 versus 2.88, p < 0.001; median Spearman correlation coefficients: 0.81 versus 0.48, p < 0.05. There were no statistically significant differences in patient outcomes [mortality, Glasgow Outcome Scale-Extended (GOSE), modified Rankin Scale (mRS), median time with the EVD, and length of intensive care unit (ICU) stay], or adverse events (AE). No serious adverse events were noted.

CONCLUSIONS: This is the first study to evaluate the VGuard® system, showing results of increased accuracy in measured ICP compared with the manual EVD. The VGuard® system offers an automated EVD solution, representing a step toward increased neurointensive care automation.

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author
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type
Contribution to journal
publication status
epub
subject
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Neurocritical Care
publisher
Springer
external identifiers
  • pmid:41872436
  • scopus:105034302639
ISSN
1541-6933
DOI
10.1007/s12028-026-02477-4
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
51965aa4-c939-43a1-b2d9-725c53a1870b
date added to LUP
2026-03-26 08:33:05
date last changed
2026-06-08 04:54:06
@article{51965aa4-c939-43a1-b2d9-725c53a1870b,
  abstract     = {{<p>BACKGROUND: Neurointensive care is moving toward more automated patient management. This study aimed to evaluate a novel external ventricular drainage (EVD) system, the VGuard® system, as a tool for intracranial pressure (ICP) monitoring and automating ventricular drainage of cerebrospinal fluid (CSF), focusing on its safety and potential to reduce complications associated with manual EVD management.</p><p>METHODS: This prospective, randomized clinical study was conducted in the Department of Neurosurgery at Skåne University Hospital, Lund, Sweden. Patients (aged &gt; 18 years) with different acute brain pathologies requiring an EVD were enrolled and randomized (1:1) to receive the VGuard® system or a manual EVD. Both systems employed a ventricular probe for simultaneous intraventricular and intraparenchymal ICP monitoring. Measurement accuracy was determined by comparing the median of absolute difference in ICP, using the Mann-Whitney U test. To further investigate the accuracy of ICP measuring, a post hoc Spearman correlation test was applied. In addition, as part of a post hoc analysis, we evaluated patient outcomes.</p><p>RESULTS: A total of 30 patients were included in the study. The VGuard® system demonstrated significantly better accuracy in ICP measurements compared with the manual EVD; median absolute difference: 1.07 versus 2.88, p &lt; 0.001; median Spearman correlation coefficients: 0.81 versus 0.48, p &lt; 0.05. There were no statistically significant differences in patient outcomes [mortality, Glasgow Outcome Scale-Extended (GOSE), modified Rankin Scale (mRS), median time with the EVD, and length of intensive care unit (ICU) stay], or adverse events (AE). No serious adverse events were noted.</p><p>CONCLUSIONS: This is the first study to evaluate the VGuard® system, showing results of increased accuracy in measured ICP compared with the manual EVD. The VGuard® system offers an automated EVD solution, representing a step toward increased neurointensive care automation.</p>}},
  author       = {{Öhman, Josefine Maria and Marklund, Niklas and Cederberg, David}},
  issn         = {{1541-6933}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Springer}},
  series       = {{Neurocritical Care}},
  title        = {{Evaluation of a Novel Automated Cerebral Ventricular Drainage System for Intracranial Pressure Monitoring and Cerebrospinal Fluid Drainage in Neurocritical Care Patients : A Prospective, Randomized Clinical Study}},
  url          = {{http://dx.doi.org/10.1007/s12028-026-02477-4}},
  doi          = {{10.1007/s12028-026-02477-4}},
  year         = {{2026}},
}