The ROTAtional-USE of Interface STUDY

Inclusion Criteria: * Age\>18 years old * Patients with chronic obstructive pulmonary disease (COPD) exacerbation or with AHRF of a different etiology needing NPPV to avoid intubation (pH \< 7.35 with PaCO2 \> 45 mmHg and partial pressure of oxygen (PaO2) \< 65 mmHg plus respiratory rate \> 25 breath/min with clinical signs of respiratory muscle distress); or as alternative to invasive ventilation with a forecast of treatment of at least 24 hours admitted to the intensive care unit, intermediate respiratory care unit, respiratory medicine service or internal medicine service according to hospital organization; or patients with chronic pulmonary disease intubated for a COPD exacerbation or for pneumonia who are early extubated and weaned in the intensive care unit with NPPV with a forecast of treatment of at least 24 hours. Exclusion Criteria: * Patient with skin breakdown or non-blanchable erythema in one of the following areas i.e., nasal bridge, nasolabial fold, cheek or scalp at hospital entrance; * Patients who refuse to consent to the study protocol; * Patient known to be pregnant; * Patients with contraindication to NPPV (lack of spontaneous breathing; gasping; anatomical or functional airway obstruction; gastrointestinal bleeding or ileus; coma; massive agitation; massive retention of secretions despite bronchoscopy and aggressive physiotherapy; hemodynamic instability (cardiogenic shock, myocardial infarction); status post upper gastrointestinal surgery); * Patients entering hospital with asthma, with cardiogenic pulmonary edema; * Patients with tracheostomy; * Patients needing NPPV only for palliation of symptoms (relief of dyspnea) i.e., category 3 defined by the Task Force on the Palliative Use of NPPV of the Society of Critical Care Medicine; * Use of high flow nasal cannula integrated with NPPV for weaning strategy; * Pre-existing skin erythematosus diseases; * Known hypersensitivity to skin protective devices (i.e., polyurethan films, colloids, foams); * More than 2 hours of NPPV application before randomization; * Patients already included in the study protocol at an earlier stage of the hospitalization; * Refuse to wear NPPV interface due to comfort;