Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The new right PICC tip projects in the proximal right atrium , 7 .8 cm below the carina . It should be withdrawn approximately 2 - 2 .5 cm for optimal placement . Tracheostomy tube and left subclavian catheter tip are unchanged in position . The large layering left pleural effusion with adjacent atelectasis and right lower lobe atelectasis are unchanged from the prior study . There is probably a small right pleural effusion . The heart appears mildly enlarged . No new focal consolidation or pneumothorax detected .
    OUTPUT:
    
1 . The new right PICC tip projects in the proximal right atrium , and should be withdrawn approximately 2 - 2 .5 cm for optimal placement . 2 . No evidence of pneumothorax . Unchanged large layering left pleural effusion with atelectasis .