A dynamic inflammation model for neutrophil and monocyte responses in sepsis, trauma and surgery patient clusters.

Abstract

Time series clustering is applied to inflammation and neutrophil cell development markers, CD16 and CD10, in sepsis, trauma and surgery patients and a dynamical model with an inflammation function, F, is used to represent their evolution over a two month period. Five patient clusters are identified, characterised and evaluated against medical assessment scores and the literature. A dynamical model for neutrophil and monocyte cell counts and maturity has been constructed based on mass balances and cell kinetics in both blood and bone marrow. Cell proliferation and flow rates, as well as expression of monocyte HLA-DR, depend on concentrations of pro- and anti- inflammatory cytokines, IL6 and IL10, via F. A good fit with the data is obtained for each cluster and the estimated parameters correlate to illness severity. The model is a potential tool for simulation of immunomodulatory therapies.