Which strategy may be considered to optimize oxygenation during ARDS mobilization?

• A. Stop mobilization
• B. Increase FiO2 to maximum indefinitely
• C. Sedate to reduce effort
• D. Prone positioning strategies

Answer: (C)

In ARDS, oxygenation improves most reliably when you use positioning and ventilation strategies that enhance how air and blood are distributed in the lungs. Prone positioning redistributes ventilation to better-perfused areas, recruits collapsed dorsal lung regions, and reduces shunt, leading to better oxygenation and often improved overall gas exchange during mobilization. This approach has solid evidence backing its effectiveness in increasing oxygenation in ARDS and can be applied alongside mobilization with proper monitoring. Sedating to reduce effort may lower metabolic demand but does not address the lung mechanics driving oxygenation and carries risks that can complicate care. Pushing FiO2 to maximum indefinitely risks oxygen toxicity and is not a sustainable solution. Stopping mobilization defeats rehabilitation goals. Therefore, prone positioning strategies are the best option to optimize oxygenation in this context.