M T R E Advanced Technologies Medical Thermo Regulation Expertise

1. MTRE Advanced Technologies Medical Thermo Regulation Expertise July 2010 A Member of Mennen Medical Group

2. An Integrated Patient Monitoring and Temperature Management System • Combines the advantages of CritiCool with Mennen Medical’s VitaLogik Patient Monitor A Member of Mennen Medical Group

3. Whole body, Non invasive Servo control cooling therapy offers fast and precise cooling to target temperature, using the CureWrapTM – a flexible, three dimensional heat exchange garment. Cooling with care, MonitortheBeat A Member of Mennen Medical Group

4. Cool Fast • For Use on Adults or Infants • High heat exchange by 3-dimensional body coveragewith _______ _, maximizes energy transfer and provides effective induction and maintenance of mild hypothermia • Precise control of patient core temperature using the temperature control algorithm • Continuous temperature feedback enables Automatic temperature control throughout treatment • Reduces staff time and labor • Convenient and easy to use • Patient cooling is achieved in three simple steps: Simply Set, wrap & Cool A Member of Mennen Medical Group

5. Re-Warming Cool Fast, Re-warm Slow • Re-warm - Automatically Controlled and Gradual • Controlled re-warming with CritiCool pro significantly reduces the rebound increase in intracranial pressure, CritiCool pro actively controls the process of re-warming and achieves a gradual increase in temperature Cooling and Automatic Re-warming at 33.5-36.5°C for 82.3 hours A Member of Mennen Medical Group

6. Vital Signs Parameters and WaveformsOn a 12.1”TFT Display Monitor • Adult / Neonatal Mode • ECG and Heart Rate • ST Segment Analysis • Full Range of Arrhythmias • Respiration • SpO2 • NIBP • Temperature Regulation The monitoring capability has an extensive storage capability of Full Disclosure, charts, trends and event strips. Alarms with status messages of all the vital signs parameters can be configured to the needs of the patient’s clinical condition. A Member of Mennen Medical Group

7. Displayed Temperature Regulation Parameters - Cooling Cooling binary state Cooling Adult / Neonatal Core Temperature OC / OF 33.5°C Surface Temperature OC / OF Set Point temp for cooling mode A Member of Mennen Medical Group

8. Displayed Temperature Regulation Parameters - Re Warming Adult Re-Warm rate • Heating binary state Core Temperature OC / OF Surface Temperature OC / OF Target temp for re-warming mode A Member of Mennen Medical Group

9. Simply Set ,Wrap & Cool One piece, body shaped garment that facilitates wrapping of your patient. Maximize surface coverage to ensure optimal energy transfer. Simultaneous water flow through numerous channels provides superior heat exchange capacity. Bio-compatible, latex free and anti static that suits any hospital setting. Secured onto your patient using pre-attached hook & loop (Velcro) strips, it allows easy and intuitive access to your patient. Permits 72h treatment.

10. Cooling withCritiCool proClinical studies show that Cooling improves Neurological Outcome in many indications: • ROSC after Cardiac Arrest: Hypothermia has become routine practice in medical centers worldwide in patients with Return of Spontaneous Circulation after VF or Pulseless VT • Stroke: A decrease of brain temperature reduces ischemic brain injury, brain edema and intracranial pressure (ICP) • Traumatic Brain Injury (TBI): hypothermia has been shown to improve patient outcome by reducing ICP and limiting secondary brain injury after severe head trauma • Asphyxia and Hypoxic Ischemic Encephalopathy: Cooling therapy can significantly improve neurological outcomes of newborns with Hypoxic-Ischemic Encephalopathy (HIE) • Uncontrolled Hypothermia: Fever in critically ill patients, mainly neurointensive care unit patients A Member of Mennen Medical Group

11. The Need for Therapeutic Hypothermia A Member of Mennen Medical Group

12. The Need for Therapeutic Hypothermia In 2002, two randomized controlled trials published in the NEJM, prove that therapeutic hypothermia (reduction of temperature to 32-34°C) after cardiac arrest Improves neurologic & functional outcome Reduces mortality

13. ILCOR Recommendations The ALS task force of the International Liaison committee on resuscitation (ILCOR) made the following recommendation in 2002: “Unconscious adult patients with spontaneous circulation after out-of-hospital cardiac arrest should be cooled to 32°C to 34°C for 12 to 24 hours when the initial rhythm was VF. Such cooling may also be beneficial for other rhythms or in-hospital cardiac arrest”.

15. Moderate Hypothermia to Treat Perinatal Asphyxial Encephalopathy TOBY study Group, NEJM 2009 Apgar score of 5 or less or a continued need for resuscitation or, acidosis within 60 minutes after birth Moderate-to-severe encephalopathy, an absent or weak suck, or clinical seizures. Abnormal background activity of at least 30 minutes’ duration or seizures on amplitude integrated electroencephalography Results: No significant reduction in the combined rates of death and severe disability with cooling, as compared with no cooling, but a significant improvement in several secondary neurologic outcomes among survivors In this randomized, control study comparing intensive care plus total-body cooling for 72 hours with intensive care without cooling, Neonates with the following signs and symptoms were included:

16. Temperature control saves lives

17. Contact details Back to index Our address: 4 Hayarden St. Yavne P.O Box 102 Rehovot, 76100, Israel Tel: +972-8-9323333 Fax: +972-8-9328510 Visit our website: www.mtre.com