Original ArticlesProne Positioning in ARDSGordon, Ayla MD; Rabold, Erica MD; Thirumala, Raghukumar MD; Husain, Ahmad Alhaj MD; Patel, Samir MD; Cheema, Tariq MD Author Information Division of Pulmonary-Critical Care (Drs Gordon, Rabold, Thirumala, Husain, and Cheema) and Internal Medicine Residency, Department of Medicine (Dr Patel), Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania. Correspondence: Ayla Gordon, MD, Division of Pulmonary Critical Care, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212 ([email protected]). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Critical Care Nursing Quarterly: October/December 2019 - Volume 42 - Issue 4 - p 371-375 doi: 10.1097/CNQ.0000000000000277 Buy Metrics Abstract Adult respiratory distress syndrome (ARDS) is a clinical entity characterized by hypoxemic respiratory failure in the setting of noncardiogenic pulmonary edema. It is associated with significant morbidity and mortality. Prone positioning is a beneficial strategy in patients with severe ARDS because it improves alveolar recruitment, ventilation/perfusion (V/Q) ratio, and decreases lung strain. The outcome is improved oxygenation, decreased severity of lung injury, and, subsequently, mortality benefit. In this article, we discuss the physiology of prone positioning on chest mechanics and V/Q ratio, the placement and maintenance of patients in the prone position with use of a prone bed and the current literature regarding benefits of prone positioning in patients with ARDS. © 2019 Wolters Kluwer Health, Inc. All rights reserved.