PLAT and atrial fibrillation: Day 6: ﻿severe hypoxemia persisted with PaO2/FiO2 ratio was 73 leading to intubation and SaO2 improved from 85% to 91% in prone position. Day 8: ﻿patient became anuric ﻿with persistently elevated D-dimer, so tPA was given which he tolerated well. His PaO2/FiO2 ratio worsened to 136, 1 hour into heparin infusion but 48 hours post-tPA ﻿his PaO2/FiO2 improved to 188-250. Day 11: patient developed multi-organ failure with refractory hypotension secondary to atrial fibrillation and superimposed bacterial infection. He died as he was made DNR