FINDINGS:
The carina is not well delineated.  The tip probably lies approximately 2.3 cm
 above the carina.  An orogastric tube is present and extends beneath the
 diaphragm off the film.  Other NG type tube is seen extending beneath
 diaphragm, off film.  A left subclavian central line tip overlies the distal
 SVC.  No pneumothorax is detected.
 
 Cardiomediastinal silhouette is probably unchanged allowing for technical
 differences and lower inspiratory volumes.  There is upper zone redistribution
 and mild diffuse vascular blurring, consistent with CHF, similar to the .   Again seen are small bilateral effusions, possibly minimally
 improved.

IMPRESSION:
Lines and tubes as described.
 CHF, similar to prior.
 Bibasilar effusions are probably slightly improved.  Associated bibasilar
 atelectasis again noted.