A 23-year-old man is hospitalized with a femoral shaft fracture from a motorcycle collision. Thirty-six hours later, he develops tachypnea (RR 28/min), confusion, and a petechial rash over the chest and axillae. Vital signs show BP 110/68, HR 102/min, temperature 37.8°C, and SpO2 88% on room air. Arterial blood gas demonstrates hypoxemia (PaO2 65 mmHg). Chest X-ray shows bilateral infiltrates. He denies recent leg swelling. Which of the following is the most likely underlying process?

1. A)Release of marrow fat into the circulation after fractureGABARITO
2. B)Aspiration of gastric contents
3. C)Diffuse alveolar hemorrhage due to anti basement membrane antibodies
4. D)Nitrogen bubble formation in tissues
5. E)Immune complex deposition in pulmonary vessels