Ultrasonographic Assessment of the Effect of CPB Acute Lung Injury

Inclusion Criteria: * Adult patients aged (18-60 years), * elective valvular cardiac surgery with cardiopulmonary bypass (CPB). Exclusion Criteria: * • Emergency surgeries. * coronary artery bypass graft surgery * patients requiring re-exploration in the immediate postoperative period (within 2hours) * left Ventricular ejection fraction less than 40% * patients with preoperative congestive heart failure, cardiogenic shock , preoperative pulmonary edema * pre-existing severe chronic pulmonary dysfunction (defined as pulmonary disease requiring home oxygen therapy or causing shortness of breath after 1 to 2 flights of stairs) * Morbid obesity * Renally impaired patients with creatinine more than 2 mg/dl