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This problem in association with hemodynamic instability and electrolyte imbalance may lead to pulmonary and peripheral edema. Furosemide, a loop diuretic, is frequently administered to critically ill patients to increase urine output and to relieve pulmonary edema. It has been shown that diuresis in critically ill patients can improve the resolution of pulmonary edema. As a result, patient days on mechanical ventilation and in the ICU have been significantly reduced. 5 Furosemide has been shown to have important hemodynamic effects that often precede the onset of diuresis. 6-12 Francis et al11 demonstrated an acute vasoconstriction response to furosemide in patients with chronic congestive heart failure that resulted in a transient increase in left ventricular end diastolic pressure and systemic vascular resistance as well as a decrease in stroke volume index. Occurring parallel to these hemodynamic changes was …