FINDINGS:
A new left subclavian central venous catheter tip terminates in the upper SVC.
 Lung volumes are slightly low, but improved compared to the prior study.  The
 heart size is likely mildly enlarged.  The mediastinal and hilar contours are
 unremarkable.  There is crowding of the bronchovascular structures likely due
 to low lung volumes, with cephalization and pulmonary vascular engorgement. 
 No focal consolidation, pleural effusion or pneumothorax is identified. 
 Multiple old left-sided rib fractures are again noted.

IMPRESSION:
Low lung volumes.  Mild pulmonary vascular congestion.