IMPRESSION:
In comparison with the study of , the Swan-Ganz catheter has been
 removed and a right IJ sheath is in place.  The endotracheal tube and
 nasogastric tubes have been removed.  Bilateral chest tubes remain in place
 and there is no evidence of pneumothorax.
 Continued low lung volumes.  Otherwise, little change in the appearance of the
 heart and lungs.