Which of the following statements about gastric residual volumes (GRV) is true?

• A. Promotility agents should be considered when GRV remain > 250 mL
• B. GRV correlates with the total volume of fluid present in the stomach
• C. Small-bore feeding tubes should be used to draw GRV
• D. GRV can be correlated with pneumonia and mortality

Answer: (D)

Gastric residual volume reflects how much content remains in the stomach and has long been used to gauge tolerance to enteral feeding. Higher residual volumes have been linked in clinical observations to greater risk of aspiration and to worse outcomes, including pneumonia and mortality, so the statement that GRV can be correlated with pneumonia and mortality is supported by those data. It’s important to recognize, though, that routine GRV checks have limitations and are not a perfect predictor of intolerance or outcomes, so management should consider the whole clinical picture rather than relying on GRV alone.

The other ideas don’t fit as well because a fixed threshold like 250 mL to prompt promotility therapy isn’t consistently supported by solid evidence, GRV is not a direct measure of total gastric content, and sampling with small-bore tubes isn’t routinely recommended due to accuracy concerns and variable utility.