Could the use of routine bag-mask ventilation with PEEP during induction have altered the outcomes of the PREOXI trial?  

I remain skeptical about the results of the PREOXI trial and do not find it personally practice-changing. At our institution, we routinely use bag-mask ventilation (BMV) with a PEEP valve between induction and laryngoscopy, which appears to address some limitations highlighted in this study. According to the Protocol and Statistical Analysis Plan published in CHEST, the interval between induction and tracheal intubation ranged from 1.5 to 3 minutes. During this period, 88.1% of patients in the NIV group received ventilation, compared to only 31.1% in the oxygen mask group, leaving many patients in the latter group apneic and rapidly depleting their reserves. If BMV had been used in these apneic periods, the outcomes might have been different.