Related Experiment Video
Updated: Aug 6, 2026
07:16
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Prone positioning in ARDS
Stephan Ehrmann1,2, Jie Li3, Ling Liu4
1CHRU de Tours, Médecine Intensive Réanimation, INSERM CIC 1415, CRICS-TRIGGERSEP F-CRIN Research Network, Tours, France. stephanehrmann@gmail.com.
Intensive Care Medicine
|July 20, 2026
Summary
Prone positioning improves oxygenation and reduces lung injury in patients with acute respiratory distress syndrome (ARDS). Its use has expanded to awake, non-intubated patients, showing promise for improved outcomes.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
Background:
- Prone positioning has evolved into an evidence-based intervention for acute respiratory distress syndrome (ARDS).
- Initially a rescue therapy, it's now integral to lung-protective mechanical ventilation.
- The COVID-19 pandemic highlighted its use in awake, non-intubated patients (APP).
Purpose of the Study:
- To review the physiologic rationale behind prone positioning.
- To examine evidence from randomized controlled trials (RCTs) on prone positioning efficacy.
- To discuss current guidelines, practical implementation, and future research directions for prone positioning in ARDS.
Main Methods:
- Review of existing literature, including case reports and randomized controlled trials.
- Analysis of physiological effects on gas exchange and lung mechanics.
- Synthesis of guideline recommendations and clinical practice observations.
Main Results:
- Prone positioning consistently improves oxygenation in both intubated and non-intubated ARDS patients.
- It mitigates ventilator-induced lung injury by reducing lung stress and strain.
- Favorable hemodynamic effects have also been observed.
Conclusions:
- Prone positioning is a key intervention for ARDS, enhancing oxygenation and lung protection.
- Awake prone positioning (APP) shows promise but requires further validation in routine ICU settings.
- Further research is needed to address ongoing questions regarding its application in diverse patient populations.
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