Work of breathing during assisted ventilation is the portion of the driving pressure for ventilation contributed by the patient's respiratory muscles. A research team at Arkansas Children's Hospital was able to demonstrate that NAVA achieves reduced response time, work of breathing, and asynchrony with neurally triggered breaths as compared to pneumatically triggered breaths in an animal model [Heulitt]. This team was also able to show similar results in a clinical study of intubated pediatric patients with bronchiolitis [Clement]. A recently completed study at this institution looked at work of breathing in neonatal pigs comparing NIV NAVA with the unsynchronized nasal intermittent positive pressure (NIPPV) mode currently used at this hospital. Using the pressure-time product (PTP) as a measure of WOB this study was able to show that WOB was lower with NAVA. The PTP cannot be reliably used in infants on NIV because the nasal prong interface allows large air leaks at the nose and mouth, which interfere with accurate measurements.