Inclusion Criteria:

• Children 1 month- 18 years of age
• Undergoing Cardiac surgery for the first time and requiring CPB
• Surgeries for both cyatonic and acyanotic heart disease

Exclusion Criteria:

• Pre-mature babies (< 28 weeks at birth)
• Neonates
• Prior cardiac requiring CPB
• Surgeries requiring CPB > 6 hours
• Surgeries requiring second run of CPB
• Patients requiring additional steroids during first 24 hours of CICU stay
• Patient expires within the initial 24 hours CICU stay.
• Compromised immune system - that is, known immunodeficiency or use of
• immunomodulatory therapy.
• Peri-operative presence of two or more clinical or laboratory signs of active infection that were not attributable to any other cause: fever more than 100°F, heart rate or respiratory rate more than the normal range for age, white blood cell count more than 15% of the upper limit of normal, and an elevated C-reactive protein level above baseline.
• Preoperative mechanical ventilation, and preoperative need of inotropic agents or mechanical circulatory support.
• Patient already receiving steroids