Early Non-invasive Ventilation Outside the Intensive Care Unit

Inclusion Criteria: * Informed consent * Age \>= 18 years * Admission in a non-intensive-care department * Radiological evidence of new pulmonary consolidation or atelectasis * Peripheral Oxygen saturation less than 92% while breathing room air or PaO2/FiO2 ratio less than 300 at blood gas analysis * Decompensated hypercapnia (pCO2 \> 45 mmHg and pH \< 7.35) * Clinical signs of respiratory distress (dyspnoea, utilization of accessory respiratory muscles, paradox movements of thoraco-abdominal wall) in air. Exclusion Criteria: * Respiratory failure due to chronic obstructive pulmonary disease exacerbation, defined as PaCO2 \> 45 and pH \< 7.35 (in these patients NIV is considered to be the standard/first line treatment and we do not want to deny these patients the opportunity to receive this treatment because of randomization) * Severe, hypercapnic ARF defined as PaCO2 \> 45 and pH \< 7.30 * Severe, hypoxic ARF defined as PaO2/FiO2 \< 200 * Need for immediate mechanical ventilation or ICU as judged by the ICU physician in charge * Extremely poor short term prognosis (imminent death with decision for palliative treatment only) * Invasive or non-invasive mechanical ventilation during the same hospitalization due to respiratory failure. * Clear contraindication to NIV treatment: respiratory arrest, failure to correct positioning of a face mask, hemodynamic instability due to hypotensive shock, ongoing myocardial ischemia, arrhythmia, massive bleeding from upper gastrointestina…