Inclusion criteria (all must be satisfied)
gestationLess

Born before 28 weeks’ gestationLess than 48 h of ageNo more than one prior dose of exogenous surfactant administeredReceiving either:Mechanical ventilation via an endotracheal tube, regardless of ventilation settings or oxygen requirement (automatically qualify for the intervention), orNon-invasive respiratory support (any type including continuous positive airway pressure, nasal intermittent positive pressure ventilation [NIPPV], or nasal high flow) and there is a clinical decision to treat with surfactant (first or second dose)Prospective, written, informed parental/guardian consent obtained