Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest film ___ at 04 : 10 is submitted .
    OUTPUT:
    
Endotracheal tube , nasogastric tube , and left internal jugular central line are unchanged in position . Overall cardiac and mediastinal contours are stable . There are layering bilateral effusions with bilateral interstitial and airspace process which is not significantly changed given differences in positioning . No pneumothorax .