Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the prior chest radiograph performed earlier on the same date , the endotracheal tube has been advanced , and now terminates 4 .8 cm above the carina . Enteric tube terminates in the superior fundus of the stomach . Right central venous catheter introducer sheath terminates in the mid SVC . Adjacent right - sided PICC also terminates in the mid SVC . Evaluation of the lung parenchyma reveals multifocal patchy opacities likely representing underlying infectious process . This has progressed from the most recent chest radiograph performed earlier on the same date , and suggests a component of underlying vascular congestion . No pleural effusion or pneumothorax . Heart size is top - normal .
    OUTPUT:
    
1 . Appropriate positioning of the endotracheal tube terminating 4 .8 cm above the carina . 2 . Apparent worsening of multifocal opacities , presumably pneumonia , since several hours earlier , suggesting that there may be a component of vascular congestion .