Gastric distention is most commonly associated with which of the following?

Gastric distention occurs when air is inadvertently introduced into the stomach during the process of ventilation. This is most commonly associated with forceful ventilation, which can lead to excessive pressure being applied when delivering breaths. When breaths are given too forcefully or too quickly, there is a higher likelihood that the air will not only fill the lungs but also push past the lower esophageal sphincter, resulting in air entering the stomach.

In this context, it's important to understand that while underventilation and slow ventilation might not adequately inflate the lungs and could lead to inadequate oxygen delivery, they don't typically cause the same risk of forcing air into the stomach as forceful ventilation does. Endotracheal ventilation, typically performed through an advanced airway device, may reduce the risk of gastric distention compared to bag-mask ventilation but primarily due to the secured airway preventing accidental air entry into the stomach.

Thus, recognizing that forceful ventilation is significantly associated with gastric distention helps in understanding safe ventilation techniques to minimize complications during respiratory support.