Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates bilateral parenchymal opacities which have progressed over the interval from the prior study , and may represent ARDS or pneumonia . Allowing for patient positioning , the left - sided pleural effusion appears stable in size . The cardiac silhouette continues to be obscured . There is no pneumothorax . A nasogastric tube courses into the stomach and out of the field of view . A left - sided subclavian central venous line ends at the cavoatrial junction .
    OUTPUT:
    
Interval increase in bilateral parenchymal opacities consistent with ARDS and / or pneumonia . Stable - appearing left - sided pleural effusion .