Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph was obtained . Endotracheal tube , Dobbhoff tube , right PICC and bilateral apically - directed chest tubes are in unchanged position . Waxing and waning right upper lobe opacification is slightly improved on the current examination , likely due to improved aeration and decreased pleural effusion . Retrocardiac atelectasis is unchanged with decreased now small left pleural effusion . Right apical pneumothorax is unchanged to minimally improved . Left apical pneumothorax is unchanged . Cardiac size and silhouette are unremarkable . Small amount of left lateral chest wall subcutaneous emphysema is noted .
    OUTPUT:
    
Unchanged to slightly improved bilateral apical pneumothoraces with chest tubes in position . Small left pleural effusion .