Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The newly placed right internal jugular venous catheter tip projects over the expected region of the mid-upper SVC . No pneumothorax . The mediastinum is not widened . NG tube tip not well visualized . The ETT tip remains approximately 8 cm from the carina with the neck in neutral or extended position , too high in the airway . Bilateral confluent airspace opacities predominantly involving the lower hemithorax with relative sparing of the lung apices persists , unchanged . The heart is normal in size . No large pleural effusions . No acute osseous abnormality .
    OUTPUT:
    
1 . Appropriately positioned right IJ central venous catheter . 2 . Recommend advancement of endotracheal tube by at least 4 cm . 3 . Pulmonary opacities unchanged remain concerning for pneumonia / aspiration .