Inclusion Criteria:  Preterm infants being treated with high velocity nasal insufflation therapy Patients that clinically require SpO2 maintenance within the target range of 90-95% A need for supplemental oxygen as demonstrated by a required FiO2 > 0.25 at enrollment Requiring a flow rate of greater than 2 L•min-1 such that the assumed inspired oxygen fraction matched delivered oxygen fraction (definition of HVNI). A minimum of 12 manual FiO2 adjustments in the 24hr period prior to trial enrollment. Parents willing/able to complete informed consent.  Exclusion Criteria:  Current patient weight of <1000g or >2500g at time of study Major congenital abnormalities Hemodynamic instability, defined as being outside of a normotensive range based on an infant's individual characteristics by clinician Persistent unresolved apnea defined as: requiring 6 stimulations or more per 6 hours Seizures Ongoing sepsis Meningitis Clinician's concern regarding stability of the infant