Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the study of ___ , there are lower lung volumes . Continued enlargement of the cardiac silhouette with pulmonary vascular congestion . Opacification at the left base is consistent with atelectasis and effusion , though in the appropriate clinical setting , supervening pneumonia would have to be considered . Continued volume loss in the right middle lobe . Monitoring and support devices remain in place .
    OUTPUT:
    
Lower lung volumes but otherwise little change .