Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest film ___ at 08 : 23 is submitted .
    OUTPUT:
    
Nasogastric tube is seen coursing below the diaphragm with the tip projecting over the stomach . The lung apices are not included . There are layering bilateral effusions with associated compressive atelectasis of the lower lobes and stable superimposed pulmonary edema . Pneumonia can not be entirely excluded . Overall cardiac and mediastinal contours remain stably enlarged . The tip of the tracheostomy tube lies approximately 3 cm above the carina .