Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP semi-erect chest film ___ at 05 : 19 is submitted .
    OUTPUT:
    
Tracheostomy tube and right subclavian PICC line are unchanged in position . Lung volumes remain low . There are increasing patchy opacities scattered throughout both mid and lower lungs but slightly more confluent at the right base , which although these could reflect areas of patchy atelectasis , aspiration and / or pneumonia should also be considered . There is crowding of the vasculature but no pulmonary edema is evident . There is a layering right effusion . No large pneumothorax is seen . The heart remains mildly enlarged which may reflect pericardial effusion or cardiomegaly . Clinical correlation is advised . Mediastinal contours are stable .