Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderately enlarged . There is pulmonary vascular redistribution with hazy alveolar infiltrate right greater than left and moderate right - sided effusion layering posteriorly . Right - sided rib fractures are again seen . There is volume loss / infiltrate in both lower lungs . The ET tube and left subclavian line are unchanged .
    OUTPUT:
    
Markedl worsening in fluid status .