What is a recognized benefit of prone positioning in ARDS patients?

• A. Improves ventilation-perfusion matching and oxygenation
• B. Increases peak airway pressures
• C. Decreases heart rate variability
• D. Increases sedative requirements

Answer: (A)

Prone positioning improves ventilation-perfusion matching and oxygenation in ARDS. When the patient is turned onto the abdomen, the dorsal lung regions—often more recruitable but compressed when supine—inflate more evenly. The heart and mediastinal structures exert less compression on these posterior areas, and the weight distribution reduces overdistension of the ventral regions. This leads to more uniform transpulmonary pressures, better alveolar recruitment where it matters, and less shunt, which raises arterial oxygenation. In practice, this translates to improved oxygenation and is a well-supported intervention for severe ARDS when applied for extended periods. The other options don’t reflect recognized benefits: prone positioning isn’t about increasing peak airway pressures, reducing heart rate variability, or increasing sedative requirements as a therapeutic goal.