Have increased gastric residuals been linked to an increased risk for aspiration?

• A. Yes
• B. No
• C. Sometimes
• D. Not studied

Answer: (B)

The main idea is that gastric residual volume is not a reliable predictor of aspiration risk. Studies and guidelines have shown that elevated residuals do not consistently correlate with more aspiration events. Aspiration is more strongly linked to factors such as actual reflux or regurgitation into the esophagus and airway, impaired airway protective reflexes, tube misplacement, sedation, and the patient’s overall tolerance—not simply the amount of content left in the stomach at a given time. In practice, routine monitoring of gastric residuals and using them as the sole reason to interrupt feeding has not proven to reduce aspiration and can lead to underfeeding. Instead, assess overall feeding tolerance and risk factors, and adjust management based on a broader picture rather than residual volume alone.