Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tracheostomy tube remains in place . Left PICC tip seen at the lower SVC . There are hazy bibasilar opacities compatible with layering effusions , small to moderate in size , similar to prior . Superiorly , the lungs are clear . The cardiomediastinal silhouette is within normal limits . No acute osseous abnormalities although chronic changes seen at the shoulders , more extensive on the left .
    OUTPUT:
    
Persistent bilateral pleural effusions .