Patients with acute respiratory distress syndrome (ARDS) who were placed in the prone position had improved gas exchange and reduced intensity of inspiratory effort compared with the supine position, according to study results published in the American Journal of Respiratory and Critical Care Medicine.

In this feasibility study, researchers determined the intensity of spontaneous breathing via esophageal balloon in adult patients with moderate to severe ARDS (ClinicalTrials.gov Identifier: NCT03768154). Breathing intensities were compared at baseline (supine) and after being moved to the prone position. Patients were sequentially assigned to each of the following conditions: spontaneous breathing (supine); muscle paralysis (supine); muscle paralysis (prone); and spontaneous breathing (prone). Before switching from supine to prone position, patients were paralyzed with rocuronium.