Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The right - sided PICC line tip is in the right atrium 5 cm below the cavoatrial junction . NG tube tip is in the stomach . ET tube tip is 4 .5 cm above the carina . There bilateral pleural effusions and volume loss in both lower lungs .
    OUTPUT:
    
Compared to the prior study the amount of fluid overload appears worse