Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe pulmonary edema and bilateral pleural effusions have increased since previous exam . Right hemodialysis catheter has been removed . New left hemodialysis catheter is in adequate position . The ET tube has been removed . There is new tracheostomy . There is no pneumothorax . Left - sided PICC line distal end is hard to assess .
    OUTPUT:
    
Severe pulmonary edema and pleural effusion have worsened since the previous exam .