3 - Central Venous Pressure or right atrium pressure to evaluate right ventricle function.

4 - Urinary output folly catheter is fitted .

5 - Nasogastric tube is maintained open at least.

6 - hour post-extubation.

7 - Mediastinum and/or pleural drains.

8 - Rectal temperature every 15 min during the first hour and then every 30 min during the second hour then every 4 hour until the first 24 hour after operation.

4 - Invasive Monitoring:

1 - Pulmonary artery pressure (measured with a Swan -Ganz Catheter).

2 - Cardiac output (using a Swan-Ganz) .

3 - Central Venous Pressure

5 - Observational Sheet for Complications

during immediate post-operative period (31)

As the following:

1 - Alteration of systemic tissue perfusion.

2 - Hypovolemia.

3 - Impaired gas exchange.

4 - Respiratory acidosis.

5 - Respiratory alkalosis.

6 - Hyponatremia.

7 - Hyperkalemia.

8 - Hypoclcemia.

9 - Metabolic acidosis Participant inclusion criteria included those with a diagnosis of Congenital Heart Diseases undergoing their first Heart surgery, their ages ranged between (2 to 12 years old).

... Participants were excluded if there were known risks for neuralgic defect. These would include the following:1)prematurity or small for gestational age,2)clinical evidence of a central nervous system anomaly(eg,brain malformation) or insult (eg, perinatal asphyxia).