Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An endotracheal tube has been removed and replaced with a new tracheostomy . The upper mediastinal and tracheal contours are not optimally , but the tracheostomy appears within normal limits . A left - sided PICC line and right internal jugular venous catheter appear unchanged . There is still a chest tube in the left lower hemithorax , where there is persistent retrocardiac opacification and a pleural effusion , not significantly changed . A pigtail catheter has been removed from the more inferior left lower lateral hemithorax , however . The lungs appear otherwise essentially clear . There is no pneumothorax . No mediastinal air is identified . The cardiac , mediastinal and hilar contours appear stable .
    OUTPUT:
    
Status post tracheostomy . Status post removal of one of two left - sided chest tubes . No other significant change .