Los Angeles

Researchers are investigating the best way to use the prone position (lying on the abdomen) to improve survival in adults with moderate to severe Acute Respiratory Distress Syndrome (ARDS) who are on mechanical ventilation. ARDS is a serious lung condition with a high mortality rate, and while prone positioning has been shown to improve outcomes, the optimal length of each prone session is not known. This study aims to determine whether prolonged prone sessions lasting more than 48 hours are more effective and safe compared to the standard intermittent daily sessions lasting 16 to 24 hours. Participants will be randomly assigned to one of two groups: one receiving prolonged prone position sessions lasting at least 48 hours and up to 120 hours until their oxygenation improves, and the other receiving daily prone sessions lasting 16 to 24 hours. If participants' oxygen levels drop after returning to a supine position within the first 7 days, additional prone sessions may be given following the assigned duration criteria. The trial is multicenter, randomized, and will compare these two approaches to evaluate survival and safety. During the study, participants will be closely monitored for up to 90 days. Researchers will assess mortality at 28 days as the primary outcome, along with any medical problems related to prone positioning. Participants will undergo clinical evaluations to track their lung function and overall health progress throughout the follow-up period. The study will provide important information on how prone positioning duration affects survival and complications in ARDS patients on mechanical ventilation.