This manual of cardiac intensive care seeks to serve as a ready reckoner to nurses and resident doctors involved in the perioperative intensive care of patients with congenital heart disease. This manual has attempted to incorporate some of the key aspects of the general postoperative care of patients undergoing congenital heart surgery, special considerations in each type of congenital heart disease, the expected postoperative complications and their management. This book looks to specifically assist care-providers in pediatric heart programs encountered in low and middle-income countries. Therefore, there are chapters that are especially devoted to issues that are of particular significance in low resource environments. There are chapters devoted to nutrition, pulmonary hypertension, and healthcare-associated infections. One chapter is also offered on the most important considerations for establishing a PCICU in a limited-resource environment. In addition to providing key information about cardiac intensive care for CHD patients, this manual promotes the practice of critical thinking at the bedside. Successful intensive care depends in part on vigilance – the eyes and ears at the bedside looking and listening for signals that could represent early indications of clinical decompensation. Building critical thinking skills among care team members is the best way to expand the scope of vigilance to include minds as well as eyes and ears, and this manual will assist those who embrace it in those fundamental skills.