Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube tip terminates approximately 3 cm from the carina . An orogastric tube tip terminates just beyond the gastroesophageal junction , and should be advanced for optimal positioning . The heart size is top normal . Diffuse ill - defined alveolar opacities are noted , most predominantly in the perihilar regions , left lung more involved than the right . There is blunting of the costophrenic angles bilaterally , which may reflect small effusions . No pneumothorax identified . A large bulla appears to be present in the right lower lobe , and severe emphysematous changes are noted .
    OUTPUT:
    
1 . Endotracheal tube in standard position . The orogastric tube tip terminates just beyond the gastroesophageal junction and should be advanced further for optimal positioning . 2 . Diffuse airspace opacities in both lungs , primarily in the perihilar regions . Findings suggestive of moderate pulmonary edema , though , multifocal infection is not excluded . Probable small bilateral pleural effusions . 3 . Severe emphysema .