In fact, this method, if used for at least 12 hours a day, has been shown … MM is supported by the “Charité Digital Clinician Scientist for Future Driven Medicine” program of the Berlin Institute of Health (BIH). <> <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Patients in the prone group were placed in prone position while on mechanical ventilation for at least 16 consecutive hours per day up to day 28. Prone position and lung ventilation/perfusion matching in acute respiratory failure due to COVID-19. In this trial, the investigators found a … Evidence to support the prone position in the awake self-ventilating patient is in large anecdotal yet is supported by basic physiological principles including:  Reducing load on lung fields by both the abdominal content and heart  Recruitment of posterior lung segments and reduction of shunt due to reversal of atelectasis  Improved Ventilation Perfusion (V/Q) matching – caused by a shift in … All authors were involved in the interpretation of the data and in the writing and critical review of the manuscript. Severe coronavirus disease 2019 (COVID‐19) infections require admissions into emergency departments and critical care units, and despite invasive mechanical ventilation they have high mortality rates. Case characteristics, resource use, and outcomes of 10 021 patients with COVID-19 admitted to 920 German hospitals: an observational study. Importantly, however, due to the homogeneity of the studied cohort and the overall similar course of the early phase of COVID-19 related ARDS this small number was sufficient to address the key issue that high PEEP levels and the prone position in was effective in improving oxygenation in COVID-19 ARDS patients. A number of recent inter-related editorials have suggested that a subset of patients with COVID-19 induced ARDS have an unusual physiological phenotype (“L-type” phenotype), with low elastance, low lung weight, and low recruitability. MD is European Society of Radiology (ESR) Research Chair (2019–2022) and the opinions expressed in this publication are the author's own and do not represent the view of ESR. Mechanistically, fluid accumulation may play an important role in the early disease stage in COVID-19 ARDS, as suggested by lung ultrasound, and opacities by CXR and CT scan [. Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. Prone positioning is an intervention used in Acute Respiratory Distress Syndrome (ARDS) with the aim of improving oxygenation, preventing ventilator associated lung injury and, in combination with a protective ventilation strategy, has been shown to decrease mortality 1. The observed marked improvement in oxygenation and recruitment of lung volume with high PEEP is in line with the study of van der Zee in which electric impedance tomography revealed that comparable high PEEP levels were needed to stabilize gas exchange area while hyperinflation of the lung was avoided [. MD is supported by the EU ( 603266-2 ), DFG (DE 1361/14-1, DE 1361/18-1, BIOQIC GRK 2260/1, Radiomics DE 1361/19-1 (428222922), 20-1 (428223139) in SPP 2177/1), Berlin University Alliance (GC_SC_PC 27), Berlin Institute of Health (Digital Health Accelerator). 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