Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since chest radiograph 5 hours ago , no relevant change . Unchanged moderate cardiomegaly . Unchanged moderate pulmonary edema . The difference in appearance of the right hemithorax on previous radiograph is explained by patient 's rotation on previous radiograph . Unchanged lower lung volumes . Support devices are unchanged in position from prior study . Small pleural effusions are unchanged in size .
    OUTPUT:
    
Since chest radiograph ___ at 4 : 56 am , no relevant change . Unstable moderate cardiomegaly and unchanged moderate pulmonary edema . Unchanged small pleural effusions . Support devices in appropriate positions .