Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube is likely present , it s tip is obscured by the spinal fixation hardware . It does not extend to or beyond the carina . A left subclavian PICC line is present , tip probably overlies the right atrium . A right IJ central line is present , tip near SVC / RA junction . Linear densities seen over lower mediastinum and upper abdomen could represent an NG tube --___ so extends beneath the diaphragm , off the film . Extensive bilateral posterior spinal fixation hardware is noted . Inspiratory volumes are low . The cardiomediastinal silhouette is prominent , but unchanged . There is vascular plethora , consistent with CHF . There is atelectasis at both lung bases . The possibility of an early pneumonic infiltrate in this area is difficult to exclude . Small bilateral effusions are likely present . No pneumothorax is detected .
    OUTPUT:
    
Lines and tubes as described . Low inspiratory volumes . Allowing for this , there is prominence of vascular markings with vascular blurring consistent with CHF and interstitial edema . This has progressed compared with ___ . Small bilateral effusions are probably also slightly more pronounced . Bibasilar atelectasis . In this setting , an early pneumonic infiltrate would be difficult to exclude .