Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube is present . The tip lies approximately 3 .5 cm above the carina . An NG tube is present , tip extending beneath diaphragm , off film . An additional similar - appearing tube is present and overlies the upper mediastinum , slightly distal to the carina . Clinical correlation is requested --___ an additional tube been placed or does this represent tubing outside the patient ? Left subclavian central line tip lies in the region of the cavoatrial junction , unchanged . No pneumothorax is detected . Rotated lordotic positioning and low inspiratory volumes . Allowing for this , the cardiac silhouette is enlarged , but probably similar prior . Again seen is opacity at the left base grossly similar to the prior film , a probable slightly improved . The extreme left costophrenic angle is obscured by an EKG lead . Possible minimal blunting of the right costophrenic angle . Vascular plethora is noted , but could be accentuated by low lung volumes . Thin linear density at the right lung base is likely artifact rather than pneumothorax is vessels are seen projecting beyond it . On the right , there is atelectasis , but no definite consolidation .
    OUTPUT:
    
Lines and tubes as described . As noted , there is a third tube projecting over the mediastinum from a cranial approach . Clinical correlation is requested --___ this lie outside the patient ? Enlarged cardiomediastinal silhouette is grossly unchanged . Vascular plethora , consistent with CHF . This appears more pronounced than on the prior study , but is likely accentuated by technical factors . No gross effusion detected on either side . A small left pleural effusion may still be present . Suspect slight interval improvement in opacities previously seen at the left lung base .