A network of syringe-injectable bioelectronics for closed-loop therapeutic rescue

An on-body network of sensors and drug delivery implants could transform treatments for rapid-onset morbidities that require bystander intervention. During opioid overdoses, for example, lone and incapacitated victims often cannot self-administer life-saving naloxone in the minutes before respiratory collapse. However, the bulkiness of existing closed-loop systems threatens patient acceptance. Here, we present the Rapid Emergency Subcutaneous platform (RES-Q), a network of wearable sensors and syringe-implantable autoinjectors for closed-loop therapy. RES-Q implants are similar in size to FDA-approved drug rod implants and fit inside 6-gauge needles to facilitate outpatient administration. Informed by implant fibrosis fracture mechanics, RES-Q employs miniature jet injectors that deliver 0.4 mg human-relevant doses of naloxone through fibrotic encapsulation for rapid uptake. RES-Q implants communicate with wearable sensors through tissue conductivity, resulting in 25 nA standby current draws that ensure long-term functionality. In swine, we sequentially trigger multiple implants using ionic tissue communication. In rats, RES-Q detects fentanyl overdoses using wearable photoplethysmography sensors and performs autonomous, dose-titratable rescue in < 6 minutes.