Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Markedly rotated positioning , which limits assessment . On the current film , the ET tube tip appears to lie above the level of the clavicular heads , similar to the prior study . Left PICC line and right IJ tube are similar prior . An NG tube extends beneath the diaphragm off the film . There are very low inspiratory volumes , with continued vascular plethora and some degree of parenchymal opacity similar to the prior film . No gross effusion identified .
    OUTPUT:
    
ET tube tip lies above the level of the clavicular heads , similar to the prior film . The assessment of parenchymal findings is limited due to rotation , but the overall appearance is similar to the prior film .