Clinical and Billing Review of Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is a temporary technique for providing life support for cardiac dysfunction, pulmonary dysfunction, or both.

The two forms of ECMO, veno-arterial (VA) and veno-venous (VV), are used to support cardiopulmonary and pulmonary dysfunction, respectively. Historically, ECMO was predominantly used in the neonatal and pediatric populations, as early adult studies failed to improve outcomes. ECMO has become far more common in the adult population because of positive results in published case series and clinical trials during the 2009 influenza A(H1N1) pandemic in 2009 to 2010. Advances in technology that make the technique much easier to implement likely fueled the renewed interest. Although exact criteria for ECMO are not available, patients who are good candidates are generally considered to be relatively young and suffering from acute illness that is believed to be reversible or organ dysfunction that is otherwise treatable. With the increase in the use in the adult population, a number of different codes have been generated to better identify the method of support with distinctly different relative value units assigned to each code from a very simple prior coding scheme. To effectively be reimbursed for use of the technique, it is imperative that the clinician understands the new coding scheme and works with payers to determine what is incorporated into each specific code.

Figures in this Article
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Extracorporeal membrane oxygenation (ECMO) is a temporary technique for providing life support for cardiac dysfunction, pulmonary dysfunction, or both until the native organ(s) recover or other definitive therapy is implemented. Although the technique has existed since the 1970s, early failures in randomized clinical trials in adults resulted in a limited number of centers supporting the technology in patients over the age of 18 years.1 Over the past 5 years, there has been a dramatic increase in the number of ECMO cases in the adult population motivated by improved technologies and demonstration of improved outcomes in select populations.24 This article reviews the current indications for ECMO therapy in the adult population and the evidence supporting its use. Furthermore, 2015 updates to the coding and reimbursement for the therapy are discussed.

For decades, severe respiratory and cardiac failure have been associated with heroic efforts, high costs, and frequent mortality. For the most severe cases of ARDS and acute heart failure, mortality can approach or exceed 50%, respectively.58 Although mortality rarely occurs because of the primary insult, patients will frequently develop shock and multisystem organ dysfunction and ultimately die of withdrawal of support in what is perceived to be a futile state. The thought of providing temporary extracorporeal support to allow stabilization of other end organs and allow definitive treatment of the primary organ has been available at a few specialized centers for decades.912 However, with the development of many new technologies, the use of extracorporeal support has continued to increase.2 What was once believed to be a rare salvage therapy is now rapidly becoming a commonly considered, potentially effective option in high-mortality situations.13,14

ECMO is, in essence, cardiopulmonary bypass that has been optimized for weeks rather than hours of operation. A typical circuit (Fig 1) has a venous inflow that draws blood from the patient’s venous circulation into a pump, pushes that blood through an artificial lung (oxygenator), and returns the oxygenated blood to the patient’s venous circulation (veno-venous [VV] ECMO) for circulation to the lungs or the patient’s arterial circulation (veno-arterial [VA] ECMO) for cardiopulmonary support. In the adult patient, VV ECMO support is achieved through cannulae in either the internal jugular and femoral vein or using newer dual-lumen internal jugular cannulae (Fig 2). For VA support, there are a multitude of cannulation options. Typically, percutaneous adult support is achieved via the femoral artery and vein. Central cannulation is used after failure to wean from cardiopulmonary bypass or when sufficient flow cannot be obtained from peripheral cannulation.

Figure 1 –  A, B, Diagrammatic representation of veno-venous (A) and veno-arterial (B) extracorporeal membrane oxygenation. (Image courtesy of MAQUET Cardiopulmonary AG.)

Image not available.

Figure 2 –  Image of the AVALON ELITE Bi-Caval Dual Lumen Cannula. (Image courtesy of MAQUET Cardiopulmonary AG.)

Image not available.

Over the past decade, multiple technological innovations, including centrifugal pumps and polymethylpentene oxygenators, have made it easier and safer to implement the technology. There are also a variety of pump-based technologies designed to temporarily support left-sided heart failure exclusively that are useful, but their discussion is beyond the scope of this article.15

The use of adult ECMO has continued to expand for both cardiac and respiratory failure. There has been explosive growth in the use of adult ECMO for respiratory failure likely due to the results of studies and experience from the 2009 influenza A(H1N1) (A[H1N1]) pandemic. According to the Extracorporeal Life Support Organization (ELSO) registry reports from 2004 and 2012, the number of adult ECMO cases has dramatically expanded from around 150 reported runs in 2003 to just under 1,000 reported runs in 2011.2,9 From recent reports, it appears there has been continued acceleration of ECMO use in the adult population.

The original randomized trial of ECMO for respiratory support was published in 1979 by Zapol et al.1The trial, conducted at nine centers, involved patients with extremely severe ARDS randomized to either contemporary ventilator management or VA ECMO. Mortality in both groups exceeded 90%. Supporters of ECMO therapy are quick to identify fundamental flaws of the design, including implementation at inexperienced centers, the use of VA instead of VV ECMO for respiratory failure, the time until initiation of therapy (> 9 days) allowing continued lung injury, and a very high level of anticoagulation and subsequent bleeding.

In the neonatal population, ECMO therapy has been considered a standard of care because of the results of several randomized controlled trials.1619 However, adult data remained lacking. Since the Zapol trial, there have been a variety of case series and nonrandomized trials published on the adult population but nothing with the certainty of the neonatal literature. The frequently cited series by Hemmila et al20 from the University of Michigan detailed the experienced of treating 255 patients with Pao2/Fio2 ratios < 100 and expected mortality of > 80% at the time. The series reported a survival of 52%. There were also multiple case reports and several series detailing successful treatment of patients with specific conditions, including pulmonary embolism and pulmonary contusion.2126

After decades of disagreement on the actual efficacy of ECMO, the results of the Conventional Ventilation or ECMO for Severe Adult Respiratory Failure (CESAR) trial were published in 2009.4 In this randomized trial, patients were treated using conventional mechanical ventilation at one of many large hospitals in the United Kingdom or were transported to Glenfield Hospital in Leicester, England. Death or disability in the group transferred was 37% at 6 months vs 53% in the control group (P = .03). There was considerable controversy surrounding what on the surface appears to be a definitive result. Concerns surrounding the lack of a standardized ventilator and management protocol for patients in the control group and the fact the analyses were intention to treat and one-fourth of patients randomized to ECMO did not receive the therapy because of improvement are most commonly cited. Many consider the CESAR trial not to be a trial of ECMO but a trial of transfer of patients to a high-volume ARDS referral center that has ECMO capability.

Around the same time CESAR was published, the initial ECMO experience from the A(H1N1) pandemic was released. The first major manuscript was from The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators.27 Here, the authors compared 68 patients who received ECMO for confirmed or suspected A(H1N1) vs 133 who did not. Survival to discharge in the conventional therapy group was 87%. The patients who received ECMO were younger and had fewer comorbidities but were remarkably more ill, with 57% requiring vasopressors at ICU admission compared with 34% in the conventional therapy group and an average Pao2/Fio2 ratio of 56 on 18 cm H2O of partial end-expiratory pressure. Overall survival for this group was 75%.

Similar experiences for confirmed or suspected A(H1N1) to the ANZ ECMO group were reported by investigators in Great Britain.3 Using sophisticated matching techniques, they demonstrated a survival benefit for 80 patients referred for ECMO vs 195 patients not referred for ECMO. In contrast, the REVA Research Network in France reported their experience as well for 123 patients with influenza A (probable H1N1) receiving ECMO.28 After matching, they demonstrated no benefit to ECMO vs conventional treatment, but their matching algorithm left 51 patients unmatched who were younger with lower Pao2/Fio2 ratios with a high rate of survival.

Although the actual benefit of ECMO therapy for respiratory failure continues to be debated in the adult population, one item that is universally agreed upon is the desire to have meaningful recovery. Criteria tend to vary slightly from center to center, but in general many now use the criteria for enrollment into the CESAR trial to be the base criteria for initiation of ECMO therapy (Table 1).4 The guiding principle is that patients not have too much time, typically between 5 and 10 days, on the ventilator prior to cannulation minimizing additional ventilator-induced lung injury and that their disease state be potentially reversible. As such, patients of advanced age, with significant comorbidities and/or other terminal illness are usually excluded from consideration for therapy.

TABLE 1 ]  Criteria Used in the CESAR Trial

There are generally three indications for adult VA ECMO therapy: (1) inability to wean from cardiopulmonary bypass; (2) hypoxic, biventricular, or right-sided cardiac failure; and (3) extracorporeal cardiopulmonary resuscitation. Of note, the use of ECMO for isolated left-sided heart failure is an option, but other forms of temporary mechanical circulatory support are potentially better options that require less anticoagulation and/or supervision.15 Despite the increasing number of options, the number of adult VA ECMO cases continues to increase. The reasons for this are probably multifactorial, including acquisition of equipment and ease of use at facilities that previously did not have the technology.

Data supporting the use of ECMO for VA support are sparse. Although there exist some data to suggest that certain patients will expire without extracorporeal support, such as the intraaortic balloon pump score, predictors of survival after VA ECMO in the adult population are lacking.29Overall survival for adult VA support from the 2014 ELSO registry is 40% and from extracorporeal cardiopulmonary resuscitation, 29%.

Although the number of ECMO centers has continued to expand over the past 5 years, there are data to suggest that high-volume centers have superior outcomes. Data presented at the 2014 ELSO conference suggest that centers performing more than 30 cases/y were consistently associated with better survival. This is likely because of the sophisticated nature of the technology requiring numerous team members to execute highly specialized tasks. Protocolized management of patients is probably of benefit in addition to having emergency procedures in place. Some high-volume centers have transport programs to receive patients who have been placed on support with the plan for referral. Survival in this situation is around 60%.12

The existing current procedural terminology (CPT) codes and relative value units have been heavily revised for 2015 and reflect the increased use of ECMO in the adult population. Prior CPT codes 36822 (cannulation for ECMO), 33960 (first day of management for prolonged ECMO), and 33961 (subsequent day management) have been replaced with a complex set of codes that much better define the care provided. The new codes for adult management and cannulation are shown in Table 2.30

TABLE 2 ]  HCPCS Codes, Definitions, and RVUs for 2015 Related to Adult ECMO30

The most important changes in the codes include differentiation in the form of support being provided, VV or VA. Initiation and daily management of VV support is recorded with codes 33946 and 33948, respectively. VA support initiation and daily management are identified with codes 33947 and 33949. Additional changes in the codes help to better identify cannulation techniques and the age of the patient. Codes 33951 to 33956 help identify percutaneous cannulation, open, and central techniques in addition to the age of patients. For the adult population, codes 33952 (percutaneous cannulation for ages ≥ 6 years), 33954 (open cannulation for ages ≥ 6 years), and 33956 (central cannulation for ages ≥ 6 years) will be most commonly used.

There are also new codes to support repositioning of cannulae (33958, percutaneous; 33962, open; and 33964, central; for ages ≥ 6 years), which are to only be used on days after initial cannulae placement. New codes for decannulation have also been provided (33966, percutaneous; 33984, open; and 33986, central; for ages ≥ 6 years). Finally, there have been new codes submitted for left-sided heart vent placement (33988) and removal (33989) when placed through sternotomy or thoracotomy.

Although the new codes better define service, they also are designed to offer better clarity on what is being covered. Prior codes, depending on the state, may have incorporated critical care time as part of the management of ECMO. It is the intention of the new codes that all additional services will be billed separately. Each code has been assigned a zero-day global period. Critical care time or other appropriate evaluation and management services should be billed separately provided there is no time overlap and should be accompanied by the -25 modifier. During the first 24 h of support, daily management and repositioning of the cannulae should not be charged, as they are considered part of the initiation and cannulation codes.

Individual payers may determine when ECMO is an appropriate therapy. Centers for Medicare & Medicaid Services provide coverage for ECMO in the adult population; however, certain payers may decide ECMO therapy is only supported where there is clinical evidence it improves outcomes. Other payers may consider ECMO to be experimental and not eligible for reimbursement. Hence, one should attempt to clarify a payer’s ECMO policy and adhere to their coverage guidelines. With the issuance of the new CPT codes, it is important for payers to update their policies with the new codes. Many policies by payers are limited in scope and/or have not been updated for considerable periods of time. For example, Blue Cross Blue Shield policy in Montana greatly differs in scope from the policy in Texas, and neither has been updated with new codes.31,32 If a payer has no policy or a policy that has not been updated, a conversation with the payer should be documented with the participants in the conversation, date, and time. Each question asked should be documented along with the payer’s representative’s response. This document should be retained on file.

It is preferable to consent patients or their surrogate(s) for ECMO prior to initiation of therapy unless emergent circumstances prohibit such interaction. Discussion should include a realistic assessment of ultimate outcome. Patients’ decision-makers should be aware of complications, including bleeding, infection, machine failure, and stroke (both hemorrhagic and embolic). The consent should also list conventional therapy as an option that was declined.

With the new codes, cannulation and initiation of therapy are best documented in separate notes and may be billed by different providers. On a daily basis, a separate ECMO note should be created documenting the management of ECMO. Other critical care assessments and plans should be documented in a separate critical care note.

There has been continued growth of ECMO for both respiratory and cardiopulmonary support in the adult population. Although evidence continues to expand supporting the efficacy of ECMO, it continues to be seen by some as a salvage therapy. It is important for providers to understand the management and have institutional support to provide therapy or consider transfer of patients receiving ECMO to centers prepared to provide such care. Prior to initiation of therapy, a realistic discussion of outcome and risks should be documented. The new ECMO codes provide greater clarity in the services provided, and clear documentation and coding is required to receive appropriate reimbursement for therapy.

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.


2009 influenza A(H1N1)


Conventional Ventilation or ECMO for Severe Adult Respiratory Failure


current procedural terminology


extracorporeal membrane oxygenation


Extracorporeal Life Support Organization





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Over 11k dental patients in Sydney at risk of HIV, hepatitis exposure over poor cleaning — RT News

More than 11,000 dental patients in Sydney are in danger of having contracted HIV or other blood-transmitted diseases due to improper equipment cleaning throughout the city.

Reuters / John Gress

The ongoing probe has seen six dentists’ registration suspended and one dental practice shut down.

At the end of last year, patient complaints led to an investigation into the local dental clinic network Gentle Dentist, and infection breaches were discovered. In particular, Dr. Robert Starkenburg’s practice was closed in December.

The dentist told Fairfax Media outlet that he was “very sorry,” and that his age – 75 – had made it hard for him to follow the changing cleaning regulations.

“In the last eight years, they have upgraded the protocols a lot. I was a little lax on getting the latest protocols … [but] I have [since then] taken a couple of courses and taken steps to rectify the problem,” he said.

In February, it was revealed that the breaches in cleaning and sterilization had been more severe than considered.

Patients of several dentists’ offices were instructed to get HIV, hepatitis B and C testing.

New South Wales Health’s director of health protection, Jeremy McAnulty, stressed that the risks are“low”, and there have been no cases of blood-borne diseases so far.

Patients were written to individually, he added.

Over the past decade, some 11,250 patients have had invasive dental procedures at the Gentle Dentist, and are now all being tested.

Meanwhile, other Gentle Dentist clinics remain open.

Dr. Chan, the owner the enterprise, employs 21 dentists in two surgeries. He declined to comment on the situation to Fairfax Media.

The representative of the Dental Council of New South Wales, Shane Fryer, told the Guardian that the medics need better training in sterilization and cleaning.

“While we believe the vast majority of dentists in New South Wales are complying with the guidelines, we recognize there may be a need for a greater education within the profession <…> The risk, if indeed there is a risk, is low, the vast majority of dental practitioners do the right thing, they’re professional healthcare providers and they abide by the guidelines,” he said.

The dentists’ union, the Australian Dental Association, echoed the statement, saying the hazard of contracting blood-transmitted infections at the dentist’s was “extremely low”.

Association President Deb Crockrell, however, said that they take infection control very seriously.

“There are very rare cases. We have nearly 4,000 members in NSW and the ACT, performing more than 6 million procedures each year. The overall standard of care is outstanding. The risk of patients being infected by blood-borne diseases is extremely low.”

Digital amnesia: Mobile phones deprive users of memory skills

Reuters / Zoran Milich

While mobile phones and other devices are increasingly essential in our lives and often the main place we store all our information and manage our daily schedules, Kaspesky lab has published a study attempting to uncover how modern technologies affect human memory skills.

Kaspersky lab surveyed 6,000 users aged 16 and older in eight European countries. The results showed that 49 percent of UK respondents do not remember their parents’ telephone numbers, 57 percent haven’t memorized the number for their place of work, 71 percent of parents can’t dial their children off the top of their head, and 87 percent don’t know the number of their children’s schools by heart. On the other hand, 47 percent can recite the phone numbers they had when they were between age 10 and 15, likely before devices had such large memories.

The study also reveals that some groups become more distressed than others when information on their devices is lost, with 44 percent of women and 40 percent of users between the ages of 16 and 24 becoming“overwhelmed by sadness.” Moreover, 25 percent of females and 38 percent of younger users would become totally frantic in such an event, given that their phones or tablets are the only place their images and contacts are saved.

Researchers from Kaspresky Lab called that phenomenon “digital amnesia.”

Forgetting information is not always a bad thing. Like the storage capacity of a digital device, human memory is not limitless. If we do not use particular information, it will gradually fade until we forget it. The human brain can also overwrite outdated bits of data with more topical ones.

“We are beautifully adaptive creatures and we don’t remember everything because it is not to our advantage to do so. Forgetting becomes unhelpful when it involves losing information that we need to remember,” said Dr. Kathryn Mills, UCL Institute of Cognitive Neuroscience, London, PR Newswire informs.

The problem is, however, that people do not pay enough attention to the security of their devices, which increases the risk of losing information, the study says. Only 27 percent of respondents install extra security on their smartphones and 23 percent on their tablets, while 22 percent people do not use additional security for any of their devices.

“Connected devices enrich our lives but they have also given rise to Digital Amnesia. We need to understand the long term implications of this for how we remember and how we protect those memories,” concluded David Emm, Principal Security Researcher, Kaspersky Lab.

Why China won’t listen to Western scientists about genetically modifying the human embryo

We’ve avoided a nightmare before, so surely we can do it again. That’s what scientists hope for with the technology that may soon allow the genetic modification of human embryos.

Messing about with the future of humanity.

In March, a group of US scientists requested that scientists around the world should not genetically modify human embryos. They argue that the technology is not ready yet, but, less than a month later, a group of researchers in China did just that.

The technology in question—referred to as CRISPR—can be used to make genetic modifications with greater precision than ever before. It works like a biological find-and-replace tool: you can program the system to seek out a certain genetic sequence in a cell, and then replace it with another sequence.

It is also cheap and easy to use, and could one day soon be used to treat genetic disorders, such as sickle cell anemia, and eliminate heritable diseases, such as cystic fibrosis. Yet the flip-side of the technology is the creation of genetically enhanced humans and the social upheaval that could follow.

The Chinese scientists were trying to fix the faulty genes in embryos that are known to cause the blood disorder thalassaemia. They justified their experiments by saying that they used abnormal embryos that were going to be discarded anyway. But there is a worry that not all scientists in China will stop there—and some may experiment with viable embryos.

This opinion was expressed by three Nobel laureates on June 29 at a meeting in Lindau, Germany. Michael Bishop, Richard Roberts, and Elizabeth Blackburn—who are well-known for their work in genetics—said that while Western scientists will be able to come to a global consensus regarding the use of CRISPR, they are not sure if scientists in China would agree to a moratorium on genetic modification of human embryos.

CRIPSR technology, they argued, is not close to ready for tests in humans. If such tests are carried out in embryos, the changes made will be passed on to their descendants, which could have adverse effects on future humans. Though CRISPR is the most precise tool for genetic modification, it is not precise enough.

When they faced a similar situation four decades ago, scientists showed the world how a global consensus on the use of genetic engineering with unknown risks should be handled.

In 1974, the Stanford biochemist Paul Berg found a way of mixing the DNA of different species to create a hybrid organism (if the new DNA is injected in to a host cell). The two species involved in Berg’s experiment were the monkey virus SV40, which is known to cause cancer, and E. coli, a bacteria that is found in the human gut. He feared that, if the hybrid organism escaped the lab, it could cause cancer.

More broadly, Berg’s technology could allow others to mix even more dangerous species. That’s why, even though the hybrid DNA was ready, Berg never injected it in to a host cell. Instead, he set about organizing a conference on his “recombinant DNA” technology.

At the Asilomar Conference—named after the conference center it was held in—scientists agreed on common principles of using recombinant DNA safely and set guidelines, such as prohibiting the experiments from being run in contagious, disease-causing microbes. Today recombinant DNA technology is widely used, and there haven’t been any major issues that have arisen from its use because scientists followed guidelines.

Now scientists are looking to organize another Asilomar-like conference to discuss the risks of genetic engineering humans with CRISPR. This time, however, the world is a different place. The 1974 conference had 140 scientists, which included the majority of those who worked on recombinant DNA technology. CRISPR is so widely used that it would be hard to fit all of them in one room.

More importantly, those 140 scientists at Asilomar came from only a handful of Western countries. Now, among researchers from other non-Western countries, China will also be at the table. And nobody is sure if the country that is spending large sums to become a world leader in biomedical science will be ready to agree to rules set by Westerners.

In 2013, according to China’s National Bureau of Statistics, the state invested more than $190 billion on scientific research and development. “These days, if you pick up a biology journal, the list of authors invariably contains one or many Chinese names and often many of them are leading authors,” Nobel laureate Peter Agre said at a session in Lindau on the rise of science in the developing world.

“I don’t think China wants to take a moratorium. People are saying they can’t stop the train of mainland Chinese genetics because it’s going too fast,” Huso Yi, the director of research at the Chinese University of Hong Kong Center for Bioethics told the New York Times.

In 2014, Quartz reported about a Shenzen-based company that is mapping the genes of math geniuses in the hope of screening embryos to pick the smartest one. Traits such as intelligence are heritable, but their genetic basis is known to be quite complex. The company doesn’t do any genetic engineering, but if it’s successful in understanding the complexity of genes and has a technology to engineer the embryo then there would be great temptation to use it.

“Confucian thinking says that someone becomes a person after they are born. That is different from the United States or other countries with a Christian influence, where because of religion they may feel research on embryos is not ok,” Deng Rui, a medical ethicist at Shanxi Medical University, told the New York Times.

Leading scientists in China do recognize that CRISPR is not ready for use in viable human embryos. The April paper, according to what Richard Roberts said at Lindau, was an excellent cautionary tale since the researchers only managed to replace a faulty gene in a handful of embryos of the 86 that were tested. Worse still, there were other unintended genetic changes made, which is something it was hoped CRISPR would avoid.

But, as Zhai Xiaomei, a member of the country’s National Medical Ethical Committee and a professor at Peking Union Medical College told the New York Times, “Inside China, there are people who are opposed to international standards, citing cultural differences. This force is actually quite powerful sometimes.”

This Car Runs For 100 Years Without Refuelling – The Thorium Car

If your car was powered by thorium, you would never need to refuel it. The vehicle would burn out long before the chemical did. The thorium would last so long, in fact, it would probably outlive you.

That’s why a company called Laser Power Systems has created a concept for a thorium-powered car engine. The element is radioactive, and the team uses bits of it to build a laserbeam that heats water, produces steam, and powers an energy-producing turbine.

Thorium is one of the most dense materials on the planet. A small sample of it packs 20 million times more energy than a similarly-sized sample of coal, making it an ideal energy source.

The thing is, Dr. Charles Stevens, the CEO of Laser Power Systems, told Mashable that thorium engines won’t be in cars anytime soon.

“Cars are not our primary interest,” Stevens said. ”The automakers don’t want to buy them.”


He said too much of the automobile industry is focused on making money off of gas engines, and it will take at least a couple decades for thorium technology to be used enough in other industries that vehicle manufacturers will begin to consider revamping the way they think about engines.

“We’re building this to power the rest of the world,”Stevens said. He believes a thorium turbine about the size of an air conditioning unit could more provide cheap power for whole restaurants, hotels, office buildings, even small towns in areas of the world without electricity. At some point, thorium could power individual homes.

Stevens understands that people may be wary of Thorium because it is radioactive — but any such worry would be unfounded.

“The radiation that we develop off of one of these things can be shielded by a single sheet off of aluminum foil,” Stevens said. ”You will get more radiation from one of those dental X-rays than this.”

Here’s what Chernobyl looks like today

If you’ve ever wondered what Earth would look like if humans disappeared overnight, this video may be the closest you’re going to get. In a haunting walk-through of the Chernobyl reactor and the surrounding town of Pripyat, Derek from Veritasium shows us what a town looks like after it’s been deserted for 30 years. And it’s surprisingly peaceful.

 Watch the video. URL:

The Chernobyl disaster took place on 26 April 1986. At the time, the residents were told they’d have to evacuate for two weeks at the most, and so the majority left everything they owned behind. What remains is a snapshot of the Soviet world 30 years ago, weathered by the passing decades.

What’s particularly interesting is the way that the forest has quickly reclaimed the town, with plants and animals thriving in the ruined civilisation. In fact, if it wasn’t for the Geiger counter angrily beeping away, you could easily believe that this was a pristine piece of wilderness.

But although it’s invisible, the radiation has definitely left its mark, creating what’s known as the ‘red forest’ near Chernobyl reactor number four, where the nuclear disaster occurred. The intense amount of radiation dumped in the area following the meltdown killed all of the trees, making their leaves turn an autumnal red.

Check out Derek’s beautiful but sad footage above to see what the site of humanity’s greatest nuclear disaster looks like today. And don’t forget to check outUranium – Twisting the Dragon’s Tailthe documentary Derek was filming while visiting Chernobyl. It’s going to be awesome.

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