assessment of cardiac and mediastinal contours is difficult due to marked patient rotation on the current exam. the endotracheal tube is unchanged in position. left internal jugular central line has its tip in the proximal svc. there continue to be layering bilateral effusions with bibasilar airspace opacities likely reflecting compressive lower lobe atelectasis. in addition, there is more pronounced hazy opacity throughout both lungs which likely reflects worsening moderate pulmonary edema. no pneumothorax.