Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Midline sternotomy wires and mediastinal clips are again noted . There is a left IJ Swan - Ganz catheter with its tip again noted to enter the left pulmonary artery . The endotracheal tube is poorly visualized . A nasogastric tube extends inferiorly along the thoracic midline though the tip is excluded from view . Overlying EKG leads somewhat limit the assessment . There are bilateral pleural effusions which are similar to the prior exam . No large pneumothorax . Cardiomediastinal silhouette stable . Bony structures intact .
    OUTPUT:
    
Interval placement of an NG tube with its tip extending along the thoracic midline though the tip is not within the imaged field . Other support lines and tubes appear stable though the endotracheal tube is not clearly visualized . Small layering bilateral pleural effusions unchanged .