Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable supine chest film ___ at 23 :34 is submitted .
    OUTPUT:
    
Interval intubation with endotracheal tube having its tip approximately 4 .5 cm above the carina . Interval placement of a nasogastric tube which courses below the diaphragm with the tip not identified . The left internal jugular central line is unchanged in position with its tip in the proximal SVC . Status post median sternotomy with stably enlarged cardiac and mediastinal contours . Increased lucency overlying the right hemidiaphragm likely related to recent exploratory surgery in this patient with known free intraperitoneal air as documented on a lateral decubitus abdominal study dated ___ at 15 : 25 . Increasing perihilar fullness which may reflect a fluid replete state , as there is no overt pulmonary edema . Increasing opacity in the retrocardiac region likely reflects increasing atelectasis , although superimposed infection can not be excluded . Possible layering left effusion .