Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi supine chest film ___ at 04 :30 is submitted .
    OUTPUT:
    
Endotracheal tube has its tip 4 cm above the carina . A right internal jugular central line has its tip in the mid to distal SVC . A nasogastric tube is seen coursing below the diaphragm with the tip not identified . Interval reduction in lung volumes with appearance of patchy bibasilar opacities most likely representing atelectasis , although aspiration or pneumonia should also be considered . There is possibly a layering left effusion . Crowding of the pulmonary vasculature with no overt pulmonary edema . No large pneumothorax is appreciated , although the sensitivity to detect pneumothorax is diminished given semi-supine technique .