Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable supine chest film ___ at 22 :33 is submitted .
    OUTPUT:
    
Tracheostomy tube and right subclavian PICC line are unchanged in position . Overall cardiac and mediastinal contours are difficult to assess due to the bilateral diffuse airspace and interstitial process which appears to have slightly worsened likely reflecting worsening pulmonary edema , although a worsening pneumonia should also be considered . There are likely layering effusions . No pneumothorax is appreciated , although the sensitivity to detect pneumothorax is diminished given supine technique . A gastrostomy tube is in place . Residual contrast is seen within non-distended transverse colon .