A patient with pancreatitis and pulmonary edema is placed on…

A patient with pancreatitis and pulmonary edema is placed on a mechanical ventilator. The initial ABG results on 100% oxygen are: pH 7.36, PaCO2 42 mmHg, PaO2 173 mmHg, HCO3 23 mEq/L with a calculated A-a gradient of 438 mmHg. Based on the A-a gradient, what pathophysiology is most likely?