The Acute Respiratory Distress Syndrome, Mechanical Ventilation, and the Prone Position

The acute respiratory distress syndrome is a devastating, often fatal inflammatory condition that probably affects more than a million patients throughout the world each year.1 Since its description over 30 years ago,2 this syndrome has claimed the attention of clinicians and researchers because it is associated with an extremely high mortality rate and is difficult to treat, and because the pathophysiology of the disorder is unique.The common denominator in the acute respiratory distress syndrome is hypoxemia. Virtually all affected patients require mechanical ventilation to improve arterial oxygenation and minimize the energy costs of breathing. Ironically, the focus on normalizing . . .