phosphorus help in the metabolism of carbohydrates, protein, fats, maintenance of acid-base balance, promote white cell, while hypophosphatemia can occur in increased urinary losses, vomiting, diarrhea and hyperventilation and the patient at the acute stage are suffering from confusion, seizures, coma, chest pain, munbness, tingling of fingers and lips, decreased muscle strength.(17). The patient at chronic stage with hypophosphatemia are suffering from memory loss, bone pain, lethargy, joint stiffness, and cyanosis, and the risk factors for hypophosphatemia after rapier heart surgery are respiratory alkalosis, increased urinary losses, diuretics, reduced intestinal absorption and it is common among Down syndrome patients, vomiting and diarrhea . (18). At least three normal defense mechanisms are altered in CCU patients, which may make them more vulnerable to ingested bacteria:1)no salive,2)pH alterations, and (3)