IMPRESSION:
There is stable mild pulmonary and interstitial edema.  Bibasilar
 air space opacities are now noted with at least an associated left effusion
 and likely a smaller right effusion.  These findings may be related to
 pulmonary edema, but also could reflect a partial lower lobe atelectasis or
 superimposed pneumonia.  No pneumothorax.  Left subclavian PICC line is seen
 with its tip in the distal SVC.  A nasogastric tube is seen coursing to at
 least the distal esophagus with the tip not definitely identified.  No
 pneumothorax.  Overall cardiac and mediastinal contours are stable given
 differences in positioning.