A patient with severe ARDS is mechanically ventilated in the prone position. Suddenly, the peak airway pressures increase significantly, oxygen saturation drops, and breath sounds are diminished on the left side. The patient's trachea is deviated to the right. What is the most likely diagnosis and immediate intervention?
✓ Correct Answer: Option B
The sudden increase in peak airway pressure, desaturation, diminished breath sounds, and tracheal deviation is classic for a tension pneumothorax. Immediate needle decompression on the affected side (left) is life-saving.