Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest film ___ at 05 :56 is submitted .
    OUTPUT:
    
Left internal jugular central line , endotracheal tube , and nasogastric tube are likely unchanged position , although the tip of the nasogastric tube is not included on the image . There continue be layering bilateral effusions with slightly improved mild to moderate pulmonary edema . No pneumothorax . Overall cardiac and mediastinal contours are difficult to assess due to the patient 's marked rotation on the current study .