Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with the immediate prior study , endotracheal and enteric tubes have been removed and a tracheostomy has been placed , which ends 4 .5 cm from the carina . The left - sided PICC line ends in the upper SVC . The moderate left pleural effusion appears to have decreased , now small , though this may be due to changes in positioning . The left perihilar opacity may have improved slightly as well . Right base consolidation continues to improve . Heart size is top normal and unchanged . Spinal fusion hardware projects in unchanged position .
    OUTPUT:
    
1 . New tracheostomy in good position . 2 . Possible slight improvement in left - sided effusion , although this may be due to patient positioning .