病人診斷為急性呼吸窘迫症候群（ARDS），動脈血氣分析顯示對高濃度氧氣無反應。下列何種姿勢最能改善病人的氣體交換？
A client is diagnosed with acute respiratory distress syndrome (ARDS). The nurse observes the client's arterial blood gas (ABG) results show severe hypoxemia refractory to oxygen therapy. Which position is most effective to improve gas exchange for this client?
- ALeft lateral decubitus position左側臥位
- BSupine position with head of bed at 45 degrees床頭抬高 45 度的仰臥位
- CProne position✓ 正解俯臥位
- DHigh Fowler's position高福勒氏臥位（High Fowler's position）
ARDS 病人肺部塌陷多發生在背側，採取俯臥位（Prone position）能減少心臟對肺部的壓迫，促進肺背側肺泡擴張，改善通氣血流比值。該姿勢在重症監護中已被證實可顯著降低死亡率，是針對嚴重 ARDS 的關鍵生理適應處置。
In clients with ARDS, lung collapse occurs predominantly in the dorsal regions. Prone positioning reduces compression of the lungs by the heart and promotes recruitment of dorsal alveoli, improving ventilation-perfusion matching. This position has been proven in critical care to significantly reduce mortality and is a key physiologic intervention for severe ARDS.
美國 ICU 常規運用俯臥位協議（Prone protocol）；台灣臨床單位因人力需求較高，俯臥位操作常需跨領域團隊（護理、醫師、呼吸治療師）共同評估。