Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable supine chest radiograph ___ at 20 :47 is submitted .
    OUTPUT:
    
Endotracheal tube has its tip 4 .5 cm above the carina . Intra-aortic balloon pump has its tip 3 cm below the top of the aortic knob . Femoral Swan - Ganz catheter has its tip in the pulmonary outflow tract . There is diffuse bilateral predominantly central parenchymal airspace process most consistent with severe pulmonary edema , although pulmonary hemorrhage or a diffuse infectious process should also be considered . Clinical correlation is recommended . There is moderate gastric distension . No pneumothorax is seen , although the sensitivity to detect pneumothorax is diminished given supine technique . The heart is mildly enlarged which may reflect cardiomegaly , although pericardial effusion should also be considered .