 In treating heart failure patients as a population, diuretic resistance is encountered commonly and escalating doses of furosemide may be utilized to achieve fluid loss 15. Clinically, use of high-doses of loop diuretics is associated with greater rates of clinical events such as mechanical ventilation and myocardial infarction compared to low-dose loop diuretics 16. High-dose loop diuretic administration is associated with worsening renal function 17, increased length of hospital stay and greater in-hospital mortality 17-19. There is in fact a linear correlation with diuretic dose and mortality 20. 