Related Experiment Video
Updated: Dec 19, 2025

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Airway Pressure Release Ventilation Combined With Prone Positioning in Acute Respiratory Distress Syndrome: Old
Si Jia Lee1, Yilin Lee, Andrew Kong
1From Department of Surgical Intensive Care, SingHealth, Singapore.
Abstract:
Airway pressure release ventilation (APRV) shares several overlapping mechanisms with prone positioning in improving ventilation-perfusion mismatch in patients with acute respiratory distress syndrome (ARDS). However, the combination of APRV and prone positioning is seldom performed because assist/controlled ventilation remains the mainstay ventilatory mode. We describe 5 cases of severe ARDS where APRV and prone positioning were applied. All patients' partial pressure of arterial oxygen (PaO2):inspired oxygen concentration (FiO2) ratios improved after treatment, and 3 patients were extubated within 72 hours of turning supine. In our experience, APRV can be safely used in the prone position in a select subgroup of ARDS patients with resulting significant oxygenation improvement.
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