Equipment options. Chassis: With bottle holder Without bottle holder. Measuring modules: Agas with CO2 Agas with CO2 + O2

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1 Equipment options Chassis: With bottle holder Without bottle holder Measuring modules: Agas with CO2 Agas with CO2 + O2 Profilungs system: Profilungs Profilungs with patient metabolic Humidifiers: Willamed PHM1000 Willamed PHM5000 Willamed Aircon Profilungs Willamed PHM1000 Willamed PHM5000 Willamed AIRcon

2 CHIRANA s.r.o. Námestie Dr. A. Schweitzera Stará Turá Slovak Republic tel.: +421 (32) fax: +421 (32) Registered trade marks: Chirana /2013/11

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4 The production company CHIRANA s.r.o., Stara Tura The production company CHIRANA s.r.o., Stara Tura is part of a group of companies MOC Stara Tura. Parent company M.O.C. Stara Tura was established in 2001 as a project of preservation and further development of manufacturing medical equipment brands CHIRANA in Stara Tura. Milestones of mechanical engineering tradition and CHIRANA brand development in Stara Tura: Czech industrialist František Michera laid the foundations of machinery production in Stara Tura. New factory focusing on production of components for water meters and gas meters was established Manufacture of injection technique from a disposed factory Injecta Kraslice in the Czech border region was delimited to the factory in Stara Tura. Its product range has gradually expanded to include sterilization, inhalation and investigative techniques, surgical instruments and other medical equipment products Under the then name of Precise Mechanics - PREMA Stara Tura the factory reached one of the first international successes at the World Expo in Brussels (Grand Prix was awarded to its world novelty - Big bronchoscopic set) Merge of all manufacturers of medical equipment in the Czech Republic and Slovakia to one production-economic unit. Factory in Stara Tura became the leading national company with affiliated national factories CHIRANA PRAGUE and CHIRANA BRNO The manufacturers of medical technology were integrated into a single entity which was named CHIRANA factories of medical technology, trade union enterprise Stara Tura the first production series of dental units under the brand Chiradent was produced in Stara Tura in 3rd quarter of The department of development and production of respiratory and anesthetic techniques also underwent dynamic development Expansion of the production plan, inclusion of dental tools assortment (initially produced on the basis of licenses by KaVo), later replaced by products from its own developmental workshops Transformation from state company to public limited company. Privatization and division of the company into several separate business units Establishment of employee-management company M.O.C. and formation of the group M.O.C. Stara Tura M.O.C. becomes exclusive owner of the international and national CHIRANA. During the full history of Stara Tura nearly respiratory and anesthetic devices (N5, N6, N7, N8, Chirolog, Venar, Chirana AURA) were produced under the brand CHIRANA. More than 100,000 dental units (ErgoStart, practices, SMILE and Chirana CHEESE) were produced in CHIRANA brand Stara Tura by 2013.

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6 Chirana AURA Servoventilator Chirana AURA is a modern modular device for artificial lung ventilation suitable for adults, children, infants and neonatal patients. It represents the connection of high level of security with wide range of advanced features. It has all the modes of mechanical ventilation available in the world so far. In addition to the usual breathing modes, it is the only one in the world with multilevel programming mode ventilation (MLV), ventilatory support by continuous flow (CFV) and also the unique solution to maintain the desired minute ventilation of patients for each ventilation mode implemented by servocontrol minute ventilation (MVs).

7 Chirana AURA Unique concept for unique solutions! Chirana AURA is a device developed to meet all your requirements in order to considerably facilitate the process of human life rescue. In the device Chirana AURA there are implemented parameter values that are totally comprehensive in terms of real applications on patients, not only in the range but also in terms of content, covering the entire spectrum of patients ranging from neonates to adults with a possibility of application in patients with the most severe lung damage. The algorithm of ventilation control is based on pulmonary mechanics analysis. In practice it rescues human lives in situations where other modes of ventilation are no longer able to provide gas exchange in the lungs. MLV provides new, more acceptable and protective alternative of lungs opening for the patients. Our solution is an intelligent, mobile, considerate! Chirana AURA offers a variety of standard and unique modes of mechanical ventilation: CMV volume control SCMV synchronized volume control PCV pressure-controlled ventilation SPCV synchronized pressure-controlled ventilation SIMV-v synchronized intermittent mandatory ventilation with volume control SIMV-p synchronized intermittent mandatory ventilation with pressure control SIMV-PS synchronized intermittent mandatory ventilation with pressure support PS Pressure Support APRV (BiPAP) Airway pressure release ventilation 2-level two level ventilation 2-level + PS two level ventilation with pressure support CPAP continuous positive airway pressure SIGH depth breath (sigh) MLV multilevel ventilation MLV-HFM high frequency modulated multilevel ventilation CFS continuous flow support MVs auto-adaptive control system based on compliance with the chosen MV NIV noninvasive ventilation

8 Chirana AURA Innovative solutions! Unique version of PCV mode is implemented in the device, which is not just a standard pressure mode, but also features automatic detection of spontaneous breathing efforts, identified by the ventilator as wanting to breathe and in order to allow the patient to do so, the mode switches to mode 2-Level ventilation (BiLevel, BiPAP). This mode has also PS - pressure support available for assisting spontaneous breathing on PEEP level, the size of which is optional. In the same basic mode (PCV) with 80% Ti setting the device fluently switches to APRV. Chirana AURA thus caters to the needs of the patient basically automatically, what is a great advantage assisting the doctor. Expiratory intelligent assistance is of great benefit to patients and doctors in situations where the patient fights with the ventilator, what leads to exceeding the limit line pressure (for example coughing). In these situations, most ventilators release the pressure into the atmosphere and ground the circuit, thereby causing the set PEEP drop to zero value and collapse of the alveoli (derecruitment) unfortunately occurs in damaged lungs. The solution integrated in the device Chirana AURA is much more advanced. In situations where there is an overshoot limit line pressure, the ventilator, after evaluation of the situation by clever algorithm, releases the excess pressure so that PEEP remains preserved at all times during procedure, thus preventing collapse of the alveoli and it is not necessary to re-implement recruitment. For noninvasive ventilation (NIV) the in-built automatic compensation for gas leakage around the mask function Leakage Leakage should be emphasized. Compensation for pressure (flow) losses in endotracheal tube is solved by tubus compensation function. Apnea Backup - a standard feature. Automatic compensation of parameters of compliance and resistance of the ventilator circuit. If any hoses or humidifier are used, the device identifies and automatically compensates for changes in compliance and resistance of the ventilator circuit.

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10 Chirana AURA MLV - multilevel ventilation mode represents a worldwide unique method of programmed ventilation control on three different pressure levels with different ventilation frequencies operating at one time, leading to significant gas exchange improvement in severely damaged lungs. Ventilation control algorithm is based on the analysis of pulmonary mechanics. The benefits that MLV provides are proven in practice not only in cases of severely affected lungs (with significant inhomogeneity of distribution - ARDS, pneumonia, viral pneumonia, Diffusion confusion, H1N1 Influenza virus etc.) are indisputable, and in case of its early deployment in practice, this mode rescues human lives in situations where other ventilation modes are no longer able to provide gas exchange in the lungs. without the need for operator intervention, or lung ventilation interruption. Besides the standard parameters (static and dynamic compliance, resistance) alveolar pressures (Pai, Pae), auto PEEP (PEEP), inspiratory and expiratory time constants, modified P01, as well as other derived parameters are also monitored. The device have inbuilt mixer of inspired mixture with accurate analysis of oxygen concentration FiO2 (%). All ventilatory activity parameters are stored in the device memory for 24 hours (system of trends). MVs method implemented in the device represents a unique solution for intelligent control of all ventilation modes by changes in flow, pressure, volume and frequency, using a special algorithm that ensures the protective ventilation and operator selected minute ventilation. Proportional control of flow, pressure, volume and frequency to achieve the chosen minute ventilation is ensured even during patient s spontaneous respiration. In this method of protective ventilation, automatic adaptation of flow is also available in pressure-controlled modes (AUTO-FLOW). Automatic adaptation of pressure in pressure-controlled modes (AUTO-PRESSURE), automatic compensation of the effects of changes in the mechanical properties of the lungs (Static compliance, airway resistance) during pressure modes of mechanical lungs ventilation (AUTO-COMPENSATION). Monitoring the mechanical properties of the lungs online DATA represents unique advantage for the doctor who constantly has information about the state of the patient s respiratory organs and their trend. Monitoring runs automatically in all modes,

11 P r o fi l u n g s Computer-assisted ventilation! ProfiLungs software is the first in the world to allow for interactive processing of data not only from the servoventilator, but also from respiratory organs of the patient. Data can be evaluated, optimized, archived and certain data and procedures can be monitored in detail. Most importantly, the Auto-Start function allows for almost automatic adjustment of the device in very short time, presenting a huge benefit especially in stressful emergency situations. The operator controls the computer through touch screen. computer processed data, which significantly improves the patient s lung function diagnosis and assists the doctor to decide on further treatment strategy. Thanks to Profilungs module, information about ventilation of the patient can be transmitted for further processing, for example to Chirana central monitoring. The possibility of Optimizing f, VT, MV represents a truly unique process which optimizes gas exchange and reduces peak airway pressures that would unnecessarily traumatize patient s lungs. When using the ProfiLungs module, significant expansion of the system of monitoring and evaluation of trends is available without any time limit. In the Profilungs system there is an option of unlimited tracking of trends in terms of time, not only as regards parameters, but also events - (alarm, warning) and also each individual change of parameters of ventilation mode, or mode as a whole. Stating the exact date and time of the event and also mode changes that are recorded in well-arranged graphic, allow for very easy checks of previous events and provide a comprehensive overview of the state of the patient and the method of treatment used by the doctor. Chirana AURA device with in-built ProfiLungs system represents technology that as the first in the world presents computer assisted ventilation and optimization of patient s lung ventilation. Superstructure communicating directly with AURA ventilator evaluates ventilation parameters, but mainly respiratory organs diagnostics and provides the doctor with

12 Chirana AURA Basic Basic model of the device for adults, children and infants, which in its price range taking into consideration its parameters, achieves competitive position on the market. The device has all world-standard modes of ventilation features, including MVs (APMV), which is a unique solution of intelligent control of all the ventilation modes through changes in flow, pressure, volume and frequency according to a special algorithm that ensures ventilation protection and operator-selected minute ventilation. Thanks to the original technical solution based on patented technology, the device does not require a source of compressed air and operates with low noise. Ventilation modes CMV, SCMV, PCV, SPCV, SIMV-v, SIMV-p, SIMV-PS PS, APRV (BiLevel), 2-level, 2-level+PS, CPAP, SIGH, MVs.

13 Chirana AURA represents high standard breathing device for adults, children and infants, which in addition to normal breathing modes offers as the only one in the world also the MLV mode (programmed multilevel ventilation), ventilatory continuous flow support CFS (continuous flow) and also a unique solution for keeping the required minute ventilation of the patient in each realized ventilation mode through the so called MVs (servo minute ventilation). It also provides the option of integrating additional module Profilungs that extends monitoring and evaluation parameters of the basic unit Chirana AURA, but in particular brings the customer a number of automatic features as regards the control and adjustment process of controlled or supported breathing. Thanks to the original technical solution based on patented technology, the device does not require a source of compressed air and operates with low noise. On request the device can be equipped with CO2 monitoring. When completed with the Profilungs module in the version with metabolic monitoring of the patient, it is recommended to retrofit the device with paramagnetic O2 monitoring module. Ventilation modes CMV, SCMV, PCV, SPCV, SIMV-v, SIMV-p, SIMV-PS PS, APRV (BiLevel), 2-level, 2-level+PS, CPAP, SIGH, MLV, MLV-HFM, CFS, MVs.

14 Chirana AURA V is the latest model of Chirana AURA series. It is an advanced breathing device for all types of patients, from neonates to adults. The use of new original construction solution leads to significant expansion of limits of CHIRANA brand servoventilators use in patients in the lowest weight category, roughly from 500 grams thus significantly widening the range of satisfied users of CHIRANA brand devices. Besides normal breathing modes, it has similarly to AURA the MLV mode (programmed multilevel ventilation), ventilatory continuous flow support CFS (continuous flow) and also a unique solution to maintain the desired minute ventilation of patients for each realized ventilation through MVs mode (servo minute ventilation). It also provides the option of integrating additional module Profilungs, which extends the monitoring and evaluation of the basic parameters of the device, but in particular brings the customer a number of automatic features as regards the control and adjustment process of the controlled or supported breathing. The technical solution of the device requires an external source of compressed air, unlike previous versions of devices AURA. This makes the device much lighter. It works with minimal noise level to meet high standard parameters from the point of view of both patients and operators. Ventilation modes CMV, SCMV, PCV, SPCV, SIMV-v, SIMV-p, SIMV-PS PS, APRV (BiLevel), 2-level, 2-level+PS, CPAP, SIGH, MLV, MLV-HFM, CFS, MVs.