Patients diagnosed with ARDS have found that more than 50% of deaths are present. Treatment is ongoing, resulting in changes in treatment methods, such as treating patients with sleep posture. Inverted, which corresponds to the pathology of the patient Therefore, in order to be in line with the treatment guidelines, the objective is to study the results of treatment for patients with Severe ARDS who receive supine position care and receive prone position care. A comparative case study of nursing for both patients. 1) ARDS Factors 1 Doctor diagnosed with Influenza A, Pneumonia, 2nd, Status Epilepticus c Bacterial Pneumonia (ABAUM MDR). 2) Signs and symptoms of ARDS found that the case study in both cases, wheezing, O2 sat 1, O2 sat 95-99% is quite good. O2sat 43-91% was lower than the 1st PCO2 30-45% in the normal range but the 2nd PCO2 32-97% patients with high carbon dioxide condition 3) Treatment guidelines found that the second case, ventilator with FiO2 0.6-1.0, PEEP 18 cm.H2O indicates severe oxygen depletion. PEEP 14 cm.H2O indicates moderate severity of oxygen in the blood. 4) The formation of pressure sores. Number 1, supine position. No pressure sores were found due to the overturning of the body. Every 2 hours. Found around the red area around the neck. 5) Use of medical equipment / tools and monitoring no.1, monitoring ventilation by attaching plaster and using tape. Monitor installation to monitor vital signs Attaching the device as normal, the second is to monitor the airway by attaching the plaster and use tape to fasten it, but be extra careful as sleeping face down may cause the ventilation tube to become bent. Monitoring vital signs attached to a different device, such as the EKG Monitor. Must be switched to the back of the patient while lying prone.