Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tip of the endotracheal tube projects 4 .5 cm from the carina . Unchanged appearance of the left central line and right - sided PICC and gastric tube which remains looped in the stomach . A left chest wall battery device with a cranially directed leads projecting over the left lateral neck is present . Bilateral layering pleural effusions with adjacent atelectasis / consolidation . No pneumothorax identified . The size of the cardiac silhouette is within normal limits .
    OUTPUT:
    
Layering bilateral pleural effusions with adjacent atelectasis and / or consolidation . The tip of the endotracheal tube projects 4 .5 cm from the carina