Respiratory distress syndrome Quiz: Ace Your Exams

A 62-year-old man presents to the emergency department after being pulled out of a frozen lake. The family reports the patient was fishing when he suddenly fell through the ice; he was extricated 10 minutes later. The patient has a past medical history of heart failure with preserved ejection fraction and hypertension. His temperature is 34°C (93.2°F), pulse is 45/min, respirations are 22/min, blood pressure is 110/94 mmHg, and oxygen saturation is 85% on room air. Physical examination shows a male patient who is shivering, appears pale, and is cool to the touch. The patient can speak one- to two-word sentences at a time, but his history is limited by a persistent non-productive cough and altered mental status. The patient is subsequently intubated for airway protection and admitted to the intensive care unit on mechanical ventilation. A chest x-ray and laboratory results are demonstrated below:  


^{Reproduced from: Wikipedia}  

Which of the following is the most anticipated complication of this patient’s disease process?