A Twisted-Integrated Multifunctional Fiber Sensor for Real-Time Metabolic Monitoring and Management of Sepsis.

Sepsis-induced systemic metabolic dysregulation involves complex interactions between acid-base imbalance and glucose metabolism abnormalities. Traditional metabolic monitoring methods, which rely on intermittent blood sampling, lack sufficient spatiotemporal resolution and fail to capture the dynamic pathological changes in detail. To address this, we present a minimally invasive multifunctional fiber sensor (PGFs) with a twisted integration structure for real-time, simultaneous monitoring of pH and glucose concentrations in sepsis. PGFs integrate pH and glucose fiber sensors along with their reference electrodes through a twisted design, offering excellent flexibility, rapid response, and high sensitivity. Additionally, the twisted structure enhances the stability of the bioelectrode-organic interface and improves biocompatibility. Long-term monitoring using PGFs in a sepsis animal model allowed us to construct a temporal metabolic profile of sepsis. Furthermore, metabolic management with PGFs significantly improved the survival rate of septic mice and alleviated sepsis-induced organ damage. Mechanistic studies revealed that PGFs-based combined intervention effectively disrupted the vicious cycle between acidosis and glucose dysregulation, reducing sepsis-induced inflammation and immune responses, improving the metabolic microenvironment, and restoring energy homeostasis. In conclusion, this study provides a platform for metabolic monitoring and management in sepsis using PGFs, offering valuable insights for clinical therapeutic strategies.