Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy tube is in satisfactory position with the tip in the mid trachea . The lungs are hyperinflated with distortion of the pulmonary vasculature , most consistent with chronic changes of COPD . There is an opacity with air bronchograms in the retrocardiac region . Additionally , there is a focal opacity in the right lower lobe . A small left pleural effusion is present . There is no right pleural effusion , pulmonary edema , or pneumothorax . Pleural calcifications are noted . Allowing for technique , the cardiac size is at the upper limits of normal . The mediastinal contours are normal .
    OUTPUT:
    
1 . Bibasilar opacities , slightly more prominent on the right than the left , are concerning for multifocal pneumonia . 2 . Probable small left pleural effusion . 2 . Hyperinflation , likely due to COPD .