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Prone Position Oxygenation Response Pattern — FRCA Final MCQ

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ModerateIntensive Care MedicineProne Position Oxygenation Response PatternFRCA Final

A 60-year-old man in ICU with ARDS has been proned. His P/F ratio improves from 75 to 140 during prone positioning. On returning to supine, his P/F ratio drops back to 80. This pattern of response to proning is:

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Correct answer: D — Indicates readiness for extubation

Many ARDS patients show significant oxygenation improvement in the prone position that partially or fully reverses on return to supine – this is a TYPICAL response pattern. The PROSEVA protocol recommends prone sessions of ≥16 hours/day, cycling between prone and supine. Patients may require multiple prone sessions over several days. The benefit of proning is not just improved oxygenation but also reduced VILI (more homogeneous ventilation distribution) and reduced mortality. Proning should be continued until: P/F >150 on PEEP ≤10 AND FiO2 ≤0.6 supine after a prone session.

Reference: Guérin C et al – 2013 – PROSEVA trial; ICS – 2024 – Prone positioning