there continue be layering bilateral effusions with appearance of superimposed mild to moderate pulmonary and interstitial edema. there is also likely bibasilar compressive atelectasis. cardiac and mediastinal contours are stable. no pneumothorax. right subclavian picc, nasogastric tube and endotracheal tube are unchanged in position. interval removal of the right internal jugular and left subclavian central lines. stable thoracolumbar curvature.