Controversial in terms of safety and efficacy
No mortality/morbidity outcome benefits
May be of more benefit to extra-pulmonary ARDS than to pulmonary ARDS
Multiple methods reported
Below is only one method (Starcase<unk><unk> 
Refer to your RT for hospital protocol
Proning patient is considered a<unk><unk> 
Indication: severe ARDS < 1 wk, before onset of fibro-proliferation
Goals to recruit alveoli, maintain with PEEP at the derecruitment point, prevent cyclic collapse/VILI
Improving hypoxemia via<unk> 
Decrease ventilator-induced<unk>  injury (VILI)
Derecruitment of alveoli occurs due to:
Standard low TV ventilation in ARDS
Insufficient PEEP
High FiO2 absorptive atelectasis
Biotrauma and cytokine release (VILI) occur due to:
Dependent areas of airway are collapsed throughout TVs
Cyclic collapse causes shear injury atelectrauma with each breath
Least dependent areas inflated throughout TVs are also easily hyperinflated causing volutrauma and barotrauma, especially in:
TVs > 6 cc/kg
Pplat > 30-35 cmH2O
No mortality/morbidity outcome benefits
May be of more benefit to extra-pulmonary ARDS than to pulmonary ARDS
Below is only one method (Starcase<unk><unk> 
Refer to your RT for hospital protocol
Proning patient is considered a<unk><unk> 
Improving hypoxemia via<unk> 
Decrease ventilator-induced<unk>  injury (VILI)
Standard low TV ventilation in ARDS
Insufficient PEEP
High FiO2 absorptive atelectasis
Dependent areas of airway are collapsed throughout TVs
Cyclic collapse causes shear injury atelectrauma with each breath
Least dependent areas inflated throughout TVs are also easily hyperinflated causing volutrauma and barotrauma, especially in:
TVs > 6 cc/kg
Pplat > 30-35 cmH2O
TVs > 6 cc/kg
Pplat > 30-35 cmH2O
Lung recruitment maneuver
Pulmonary antibiotics
High frequency oscillation ventilation
Airway pressure release ventilation
Needle cricothyrotomy
Thoracic lavage
Mechanical ventilation 
Bag valve mask ventilation