Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ET tube is present , tip approximately 2 .8 cm above the carina . Enteric type tube is present , tip extending beneath diaphragm , off film . A PICC line is present , tip overlying the upper right atrium . The cardiac silhouette is enlarged can not the aortic knob is obscured , with surrounding soft tissue density , unchanged . There bilateral effusions , with layering , resulting in hazy density in the lower lungs , with underlying collapse and / or consolidation . The right effusion may be slightly larger . Artifact overlies the upper right lung laterally , obscuring underlying parenchyma . There is probable mild upper zone redistribution . No obvious pneumothorax . Mild enlargement of the azygous vein ( 12 mm ) suggests right - sided engorgement .
    OUTPUT:
    
Overall appearance is similar to the prior film . Bilateral pleural effusions with underlying collapse and / or consolidation and prominent cardiomediastinal silhouette , including obscuration of the aortic knob . Right effusion may be slightly larger . Right PICC line tip appears to overlie the upper right atrium . If clinically indicated , this could be retracted approximately 2 .7 cm to lie in the region of the distal SVC / RA junction .