Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest film ___ at 16 :41 is submitted .
    OUTPUT:
    
Interval intubation with the endotracheal tube having its tip approximately 4 .5 cm above the carinal . Right internal jugular central line and feeding tube are unchanged position . There is persistent elevation the right hemidiaphragm with a probable layering effusion and increasing lower lobe atelectasis . The left lung is unchanged in appearance . Overall cardiac and mediastinal contours are stable . No pneumothorax .