We agree with Silvia Mongodi and colleagues that non-quantitative CT was probably not the best way to assess lung morphology in patients with acute respiratory distress syndrome (ARDS). A CT scan with two slices, one obtained at 5 cm H₂O and one at 45 cm H₂O, might have been more useful to assess lung recruitability. We reasoned that a single slice would be easier to manage; however, in view of the proportion of misclassified patients, we agree that an alternative approach is needed. Lung ultrasound is an efficient bedside tool to assess lung morphology, but physicians must be aware that it requires 15 min at each level of pressure. Electrical impedance tomography (EIT) is another tool that can be used to identify responders and non-responders to positive end-expiratory pressure (PEEP) or recruitment manoeuvres. Furthermore, EIT can be used to detect lung hyperinflation, which is not possible with lung ultrasound.

中文翻译：

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急性呼吸窘迫综合征的个性化机械通气：使用错误工具的正确想法？-作者的答复。

我们同意Silvia Mongodi及其同事的观点，即非定量CT可能不是评估急性呼吸窘迫综合征（ARDS）患者肺部形态的最佳方法。进行两层切片的CT扫描，一层在5 cm H ₂ O下获得，一层在45 cm H _2下获得O，对评估肺部可征用性可能更有用。我们认为，单个切片将更易于管理；但是，鉴于分类错误的患者比例，我们同意需要另一种方法。肺部超声检查是评估肺部形态的有效床头工具，但医生必须意识到，在每个压力水平下需要15分钟。电阻抗断层扫描（EIT）是可用于识别呼气末正压（PEEP）或募集动作的反应者和非反应者的另一种工具。此外，EIT可用于检测肺过度充气，这在肺部超声检查中是不可能的。