Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy tube is present . The tip of the right PICC line extends to the cavoatrial junction . There are unchanged bilateral pleural effusions with overlying atelectasis and moderate pulmonary edema . The size of the cardiac silhouette is enlarged but unchanged .
    OUTPUT:
    
No significant interval change since the prior examination with persisting pulmonary edema and bilateral pleural effusions .