Is it all about the right? Echocardiographic metrics of right-sided venous congestion are frequent in trauma…

Cohort studyThe journal of trauma and acute care surgery· Jul 2026

Is it all about the right? Echocardiographic metrics of right-sided venous congestion are frequent in trauma patients with hemorrhagic shock.

Emmeline Leggett, Aryanne Do, Evan M Lutton … Baltimore, MD

Emergency Trauma CareCohort studyQ1IF 3.4

Abnormal TAPSE linked to over fourfold higher odds of right-sided venous congestion in hemorrhagic shock

Is it all about the right? Echocardiographic metrics of right-sided venous congestion are frequent in trauma patients with hemorrhagic shock.

Emmeline Leggett … Baltimore, MD

The journal of trauma and acute care surgery · Jul 2026 · Q1 in Critical Care

Background

Detecting right-sided venous congestion (right-sided venous congestion) is more difficult than left-sided venous congestion (left-sided venous congestion).

Methods

This is a retrospective review of quality improvement data regarding feasibility and utility of assessing right-sided venous congestion in traumatic hemorrhagic shock.

n = 182 patients

Results

poor heart function more than quadruples the odds of right-sided venous congestion

OR 4.24 (95% CI 1.17 to 13.73)

CI excludes the null - significant

More results

Seventy-eight percent were male with mean age of 48.3 years.

Forty-seven percent were African American and 42% Caucasian.

Median injury severity score on admission was 24.

Conversely, left-sided venous congestion was present in only 4.2% of patients, P<0.001.

“

Conclusion · 1 of 4

Evidence of right-sided venous congestion is prevalent in patients with traumatic hemorrhagic shock, significantly more than left-sided venous congestion at 24 hours.

Conclusion · 2 of 4

This could be an unintended consequence of life-saving massive transfusion and cardiac dysfunction and may identify a cohort of patients that would benefit from a fluid-restricted approach to resuscitation.

Conclusion · 3 of 4

Further studies are needed for validation and to better understand the etiology and clinical relevance of right-sided venous congestion in traumatic hemorrhagic shock.

Conclusion · 4 of 4

Is it all about the right? Echocardiographic metrics of right-sided venous congestion are frequent in trauma patients with hemorrhagic shock.

Is it all about the right? Echocardiographic metrics of right-sided venous congestion are frequent in trauma patients with hemorrhagic shock.

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