Table 3.

Observation periods required for diagnosis of brain death in children per Royal Decree 1723/2012.

	Exclusively clinical diagnosis	Clinical diagnosis and one instrumental testa
Preterm newborn (< 37 weeks)	48 h	The observation period may be shortened as deemed appropriate by the clinician based on the findings of performed instrumental tests and may be omitted if a diagnostic test unequivocally proves absence of cerebral blood flow
Newborn (37 weeks’ gestation to 20 days post birth)	24 h
CHILD (age 30 days-24 months)	12 h
CHILD aged more than 2 years with devastating brain injury	6 h	The established observation periods may be shortened or even omitted as deemed appropriate by the clinician based on instrumental diagnostic tests performed in accordance to the protocols established for adults
CHILD aged more than 2 years with anoxic brain injury	24 h

In case of suspected or known exposure to drugs known to have a depressant effect, the observation period should be prolonged as deemed appropriate by the clinician.

^aIn children aged less than 2 years, the instrumental test must provide unequivocal evidence of the absence of cerebral blood flow.