Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been interval replacement of the endotracheal tube with a tracheostomy tube . There is no mediastinal hematoma , pneumothorax , or pneumomediastinum . Dual - chamber pacemaker leads and right PICC are stable . Small bilateral pleural effusions are no larger . Moderate bibasilar atelectasis . No new parenchymal consolidation .
    OUTPUT:
    
Unchanged small bilateral pleural effusions . New tracheostomy tube , replacing the endotracheal tube .