Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is moderate right - sided pneumothorax that is not substantially changed in size compared to the study from the prior day . Right - sided pigtail catheter , tracheostomy tube , right - sided PICC line , and feeding tube are unchanged . There is an increased left - sided effusion that is layering posteriorly . There continues to be retrocardiac opacity compatible with volume loss / infiltrate / effusion . There is increased alveolar infiltrate bilaterally likely representing CHF .
    OUTPUT:
    
Worsened fluid status .