Soon after admission to Pediatric Intensive Care unit, Department of Pediatrics, AIIMS, Raipur, the patient will undergo screening for enrollment based on inclusion & exclusion criteria. If the patient doesn’t meet the inclusion criteria, he/she will be excluded. After inclusion into the study informed consent will be obtained from the patient’s legal guardian. Once consent is obtained patient will be randomized using computer generated block randomization with concealed allocation. The primary details and the disease status of the patient will be recorded in both the groups. Patient in the intervention group will undergo adaptive support ventilation using Hamilton G5 ventilator. The patient will be monitored for synchrony of ventilation and improvement in oxygenation and carbon dioxide, then P/F ratio, oxygenation index, lung stress index. The tidal volume and RR generated by the ASV mode will be documented.  The time taken to achieve synchronous ventilation will be documented. In control group, the conventional ventilation therapy according to unit’s protocol will be followed. Patient will be monitored in both intervention and control group and when the patient is not able to maintain either ventilation or oxygenation in any group, we would opt to transfer them to rescue mode of ventilation which is HFOV or APRV mode. The primary and secondary outcome will be recorded and followed up until discharge or death or for the next 28 days whichever is earlier in both the groups. Then data recorded will be analyzed using SPSS latest version.