Ten Centre 1987.

Methods	Randomized Multicenter Blinding of randomization: yes (sealed envelopes) Blinding of intervention: can't tell Complete follow‐up: yes Blinding of outcome measurement: yes Stratification by gestational age (25 to 26 weeks, 27 to 29 weeks) Long‐term follow‐up: Morley (1990): % survivors followed unclear
Participants	Premature infants Inborn Gestational age 25 to 29 weeks Infants randomized: ALEC = 164 Saline = 164
Interventions	Artificial lung expanding compound (dipalmitdylphosphatidylcholine and phosphatidylglycerol in saline) vs. saline administered in the pharynx if intubated, a second dose was given third and fourth doses were given if intubated at 1 and 24 hours of age
Outcomes	PRIMARY OUTCOME: Mortality SECONDARY OUTCOME: Respiratory Distress Syndrome Complications of prematurity FOLLOW‐UP: Assessed at 9 and 18 months
Notes	Randomized infants: 328 Ineligible: 20 Total evaluated: ALEC = 159 Saline = 149
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Unclear risk	Stratification by gestational age (25 to 26 weeks, 27 to 29 weeks)
Allocation concealment?	Low risk	Blinding of randomization: yes (sealed envelopes)
Blinding? All outcomes	Unclear risk	Blinding of intervention: can't tell Blinding of outcome measurement: yes
Incomplete outcome data addressed? All outcomes	Unclear risk	Complete follow‐up: yes Long‐term follow‐up: Morley (1990): % survivors followed unclear
Free of selective reporting?	Low risk
Free of other bias?	Low risk