The subjects will remain in the study for minimum of 4 hrs NIPPV therapy and total of 8 hours unless clinically still needing the NIPPV therapy. The first hour they will all receive the same standard therapies, followed by 7 hours of the therapies from the group in which they were randomized. Each 30 minutes in the study, the subject will be assessed by treating PED/PICU attending as to whether to continue the patient on the study arm, switch to a rescue arm or discontinue the patient from the study. This reassessment will be facilitated by the study investigator via a direct discussion with the treating attending physician. Furthermore, every 30 minutes the treating RT, treating PED attending or fellow, or study investigator will perform a PAS. Based on the PAS, the treating PED attending will be asked if patient needs further adjustment of the EnVe or continue present therapy. Once a subject in the NIPPV arm reaches a PAS of less than or equal to 7, the NIPPV settings may be weaned per the ACH PED NIPPV/BiPAP weaning protocol.