Page 8 - Ministerial Decree No. 550 of 2017 on the Declaration of Death

b. Separate the patient from the ventilator and provide him/ her with humidified high flow of
oxygen at 6 L/ minute (-100% oxygen) using a catheter passing through the carina of trachea.
(In children: It is sufficient to provide them with 1.5-2 L/ minute). Ensure that the catheter’s
size does not cause obstruction of the airway, and it is recommended to use a pulse oximeter
during the test period;
c. The patient is separated from the ventilator for 10 minutes, during which the patient is observed
to see any attempt to breathe, and an arterial blood sample is drawn to measure the partial
pressure of carbon dioxide, which should be higher than 8.1 kPa (< 60 mm Hg) in adults and
7. 6 kPa (55 mmHg) in children or the existence of increase of 20 mmHg more than the main
increase;

The apnea test is considered positive if there is no breathing during the period of separation of the
patient from the ventilator.

3. Diagnosis of death using cerebral criteria in children:

For declaration of death in children, the same general steps followed in adults must be followed
with some necessary adjustments according to age, which are as follows:

 Babies of 7 days - 2 months old: The observation period should be prolonged to 48 hours,
and two electroencephalogram tests should be performed with time interval of 48 hours,
and both of them show cerebral inactivity, i.e. electro cerebral silence (ECS);
 Babies of 2 months – 1 year-old: Prolonging the observation period to be 24 hours along
with performing two electroencephalogram tests with time interval of 24 hours, and both
of them show cerebral inactivity, i.e. electro cerebral silence, or one electroencephalogram
test showing electro cerebral silence, along with studying the blood flow using computed
tomography (CT) scan or using isotopes showing the lack of cerebral blood flow (CBF);
 Children over one year until adulthood:
Follow the same protocol as adults, except for the observation period, which must be at
least 12 hours.
 After adulthood: The same protocol as adults should be followed.

*In case of any misinterpretation, the Arabic version of this legislation prevails.