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great so for those of you who donamp;#39;t know me my name is Micah Fisher I run the pulmonary hypertension program at Emory Emory University Hospital which is actually what I do and the majority of my time Iamp;#39;m not so much in its best least not this year I was asked to speak about right heart failure to treat or not to treat I donamp;#39;t have any conflicts of interest but I have a lot of biases particular when it comes to flow Lynne I love flow Lynne itamp;#39;s a wonderful drug particularly for my patients Iamp;#39;m not so sure itamp;#39;s good patient good drug for the ICU patients though and weamp;#39;ll talk about that in a second weamp;#39;re going to define the types of a heart failure discuss the prevalence of right heart failure in the ICU particularly the a RDS patient population and review review some of the the suggestions in terms of therapy for those patients at this point so the types of right heart failure we see a number of different types and so I wan