Abstract
Although prone therapy is recommended to improve the mortality of patients with acute respiratory distress syndrome（ARDS）, it is often impossible to perform in burn patients due to positional limitations.
We report a patient who attempted self-immolation with 21.5% total body surface area burns on the front side of the body and ARDS due to inhalation injury in whom prone therapy was not an option due to positional limitations. We placed him in the sitting position to improve oxygenation by increasing the functional residual capacity, but postural maintenance was difficult due to burns and muscle weakness. Oxygenation was unable to be improved due to the short time in the upright position. The patient was weaned off the ventilator after 60 minutes in an upright position with multidisciplinary cooperation of nurses. A prolonged upright position may be effective as an alternative position for ARDS patients with positional limitation when prone therapy cannot be performed.
