Mantovani 1980.

Methods	Open clinical trial with alternation of treatment
Participants	Infants weighing less than 2000 g with grade 2 or 3 IVH on computed tomography (CT) scan
Interventions	Daily lumbar punctures starting 24 hours after diagnosis of IVH. 3 to 5 mL CSF was removed daily. Lumbar punctures were continued until the CSF was clear and protein concentration was < 180 mg/dL.
Outcomes	Hydrocephalus was defined as 2 CT scans with progressively enlarging ventricles. Placement of VPS. Death before discharge from hospital.
Notes	Not true randomisation. The trial authors did not state whether or not the observers of outcomes were blinded to early treatment allocation.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	The trial used an alternation method to assign participants to treatment.
Allocation concealment (selection bias)	High risk	Alternation method, allocation method not concealed to researchers.
Blinding (performance bias and detection bias) All outcomes	Unclear risk	The trial authors did not state whether or not the outcome observers were blinded to treatment allocation.
Incomplete outcome data (attrition bias) All outcomes	Low risk	The trial authors analysed almost all participants recruited to the trial.
Selective reporting (reporting bias)	Low risk	The trial authors commented on the main outcomes of hydrocephalus, shunt placement, and death. The trial did not test neurodevelopmental outcomes.
Other bias	Low risk	No other sources of bias identified