Michel Sainville Marketing Division

Advances in endoscopic

technology

Longer procedures,

deeper sedation Higher ARF risk

• Tracheal intubation Emergency department

• FOB: fiberoptic bronchoscopy

• Gastroscopy

• Enteroscopy

• TEE: trans-esophageal echocardiography

• EBUS: endobronchial ultrasound

• ERCP: Endoscopic retrograde

cholangiopancreatography

Endoscopic

procedures

ARF Statistics

Every day, in europe, the 0,01% of the population undergoes an upper endoscopy.

Europe = 73˙100 UE per day Italy = 6˙100 UE per day

The 5% of those patients develops an Acute Respiratory Failure

Europe= 3˙655 ARF per day

Italy= 305 ARF per day

Physician’s dilemma

ARF

PROBE REMOVAL

O₂ NIV STANDARD

REPEAT THE PROCEDURE

INTUBATION

INTRAPROCEDURAL NIV

PLANNED

PREDICTION ERRORS

9 ARF out of 10

Lead to procedure interruption

Europe= 789˙480 delayed UE

Italy = 65˙880 delayed UE

Every year

Costs for procedure repetition

Sedation 90 € (Propofol ,midazolam &

hydroxyzine)

EGDS 95 €

FOB 181 €

ERCP 415 €

TEE 947 €

EBUS 1120 €

Enteroscopy 1363 €

Tracheal intubation 832 € per day (stay, in Italy)

Immediate and unplanned intra-procedural ventilation

Physician’s dilemma

ARF

PROBE REMOVAL

O₂ NIV STANDARD

REPEAT THE PROCEDURE

INTUBATION

INTRAPROCEDURAL NIV

PLANNED

PREDICTION ERRORS

IN CASE OF NEED

Emergency NIV opens up new possibilities

• Deeper sedations

• Larger safety margins

• Choice of non-surgical settings

Objective

30% unit market share in 4 years

Intra-procedural NIV only (no CPAP)

EU market size

292˙400 units per year

Italian estimated market size

24˙400 units per year

Thank You