Do gastric residual volumes correlate with the incidence of regurgitation, aspiration or pneumonia?

• A. Yes, they correlate.
• B. No, they do not correlate.
• C. Sometimes they correlate.
• D. Correlation is uncertain.

Answer: (B)

Gastric residual volume is not a reliable predictor of regurgitation, aspiration, or pneumonia. Measuring how much content sits in the stomach at a single time point reflects temporary gastric contents and can be influenced by when the last feed occurred, how the measurement is taken, and variations in gastric emptying—not by the actual risk of reflux reaching the lungs. Aspiration risk depends more on airway protection and swallowing coordination, and it can occur even with normal or low residual volumes if reflux occurs or protective reflexes are impaired. Pneumonia is multifactorial, requiring both aspiration and infection, so it does not correlate neatly with GRV alone. For these reasons, routine reliance on gastric residual volumes to predict these outcomes is not supported, and clinical focus is placed on overall feeding tolerance and other signs of risk or intolerance.