Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest radiograph ___ at 04 :09 is submitted .
    OUTPUT:
    
Interval placement of a tracheostomy tube with the tip approximately 4 cm above the carina . Right subclavian PICC line continues to have its tip in the proximal to mid SVC . There has been interval appearance of moderate to large layering left and small to moderate layering right pleural effusions . Retrocardiac consolidation likely reflects partial lower lobe atelectasis given the effusion , although pneumonia can not be entirely excluded . The heart remains enlarged status post median sternotomy . There has been interval appearance of vascular congestion consistent with mild perihilar edema . No pneumothorax .