endotracheal tube, left subclavian picc line, bilateral pleural pigtail catheters, and nasogastric tube are unchanged, although the tip of the nasogastric tube is not identified. no obvious pneumothorax, although the sensitivity to detect pneumothorax is diminished given semi-erect technique. slightly worsening patchy opacity at the right base and in the periphery of the left mid lung could reflect atelectasis, although pneumonia and asymmetric pulmonary edema should also be considered. heart remains stably enlarged. mediastinal contours are unchanged.