IMPRESSION:
1.  Right internal jugular dialysis catheter again having its tip within the
 right atrium in similar position as compared to multiple prior studies.  There
 is increasing bibasilar and perihilar airspace opacities, which likely reflect
 worsening moderate pulmonary edema.  There are likely layering effusions, left
 greater than right.  Diffuse pneumonia would be less likely given the rapidity
 of interval change.  No pneumothorax is seen.  Overall, cardiac and
 mediastinal contours are unchanged, with the heart being stably enlarged.