Thank you and good morning and welcome to Senzime Q1 report webcast. I will start by giving you an update of the first quarter and after the presentation, we will open up for questions. Disclaimer. I'm very excited where we are now as a company and the solid results we reported this morning. Strong sales of SEK 7.3 million and overall growth exceeding 200% and sensor growth exceeding 500%. The strong results are driven by an increased utilization rate and new customers. The improved product country mix continued to strengthen the growth margin with +6 percentage point. Our recent issue strengthened our financial position and our outlook remains unchanged. Oh, sorry. We continue to increase shipped and installed new monitors. We now have a critical base of installed monitors in key markets, and this generates accelerating sales.
The overall sales trend is very strong, and we can also see a clear shift or pickup of the sensor sales trend due to increased utilization and also to new customers. The installed base has significantly increased, and we get a lot of requests for evals after the publication of the new guideline. This is a customer example from the U.S., and you can see that it takes about three to four months after the first shipment of sensors before the account has reached a steady state. This account is generating sensor sales of SEK 50,000 per year and per monitor. Our product system contains of two, TetraGraph and ExSpiron. TetraGraph is our gold standard legacy product, and ExSpiron comes from the acquisition of RMI.
With the acquisition of ExSpiron, Senzime's product portfolio now spans over the whole patient journey at the hospital. TetraGraph is being used in the operating room and in the post-operative care unit. ExSpiron has a much broader usage, but the point of sales, at least at the beginning, is to go to the post-operative care unit with ExSpiron where we already are with TetraGraph. Our TetraGraph system is addressing approximately 50% of all surgeries where the paralyzing or paralytic drugs are being used. These drugs often lead to complications, and it could be like, re-intubation, pulmonary collapse, or even critical respiratory events, and they can be life-threatening.
For the patients to be safe, the doctor need to extubate the patient when the muscle recovery has been 90%. This is measured in TOF ratio, so TOF ratio of 90. This picture is showing the patient during surgery and its muscle function, and also how TetraGraph can guide the patient. If you look at the top up in the top corner, you can see that the TOF ratio is 100. That means that the patient has 100% muscle function. This is the induction phase. The patient is asleep, and they will now be given neuromuscular blocking or muscle blocking agents. You can see that the muscle capacity is going down to a TOF ratio of 0. This is a very rapid phase, and it often take less than a minute.
When the TOF ratio is 0, it's safe to intubate the patient, and you can do this without damaging the vocal cords. You can see that the surgery will take place, and this is the intraoperative moment, which can take many hours in certain cases. Sometimes in the operation, you need to have the patient totally still, you need to go even further below TOF ratio of 0. You need to go into deep block, this can be guided by TetraGraph. If the patient is spontaneously recovering their muscles, you can give more paralytics. At the end of the surgery, the patient will start to recover spontaneously, but very often in the majority of cases, you will also give a reversal agent.
You can see that the muscle recovery is starting to happen. This takes the recovery phase takes longer than the induction phase, and it's also big variations between different patients. You can see that when you reach 90% of your muscle function, it's safe to extubate the patient. It's only the TetraGraph type of technology that can really guide the doctor with such precision. This is also why the market is moving towards more objective monitoring and more clinical precision. TetraGraph is a unique algorithm based on many years of research and development, and it's also based on this new electromyography technique. TetraGraph is precise and accurate. There's no need for calibration. There's really no limitation to the usage. It can be used in robotic surgery and laparoscopic surgery.
We have a great moment right now for TetraGraph. In Q1, we have won several important university hospitals and two pediatric hospitals. The pediatric sensor is really a competitive advantage for us. It's the only sensor with FDA approval, and it's specifically designed to suit the sensible skin of children. Supported by the new guidelines, we can see an significantly increase of evaluations and also tender process in Europe. There is also more studies being done with TetraGraph. Two weeks ago, new data presented at the congress from Colorado Children's Hospital , where we could see that the data really supported the safety of TetraGraph and also showed great cost savings. Last year, we signed a strategic licensing connectivity agreement with Masimo.
This week, we announced that the connectivity, we have launched the connectivity part of this agreement, and this allows the data integration between the two systems, Masimo and TetraGraph. This is a great milestone, it's not the most important part. The most important part is the licensing agreement. This is the development of a unique smart cable, which will actually replace the current TetraGraph for those accounts where they have the Root system. This development is going according to plan, and it's planned to be launched at the beginning of next year. Now to ExSpiron. ExSpiron is a unique product in the management of respiratory depression. Current standards are not ideal. Pulse oximetry is alarmingly late, and capnography is proven unreliable in non-intubated patients.
ExSpiron can detect changes in breathing pattern earlier than the current standard. The first treatment in respiratory depression is to add oxygen. The only way to measure minute volume and tidal volume in these patients that are not invasively treated or intubated is with ExSpiron. This is a slightly complicated slide, but what I would like to show here is that when you add oxygen, you actually delay the moment where you will detect a change in the respiratory pattern. It also shows that ExSpiron can detect changes in the breathing pattern 71 minutes earlier than pulse oximetry. This is a very long time, and just a couple of minutes will be the difference between life and death. ExSpiron is now fully integrated in the commercial organization. There are great synergies for the TetraGraph system.
As I said at the beginning, we are initially using the same point of sales for ExSpiron as with TetraGraph, so the post-operative care unit, where we can actually use it to optimize the throughput in the hospitals. With that, I will conclude with the outlook. A very exciting moment. The clinical guidelines are supporting our type of technology. We can see that we have an increase now in utilization and also in new customers. We can also strengthen our positioning with our pediatric sensors, and there is a significant increase in the demand and the request for evaluations and also a lot of tender processes ongoing in Europe.
We are well-positioned and confident to reach our midterm outlook, which is a net sales estimate, between SEK 275 million and SEK 325 million, a long-term EBITDA exceeding 40%, and to take 10% market share in our addressable market segment. With this, I would like to open up for questions.
Thank you. Our first question today goes to Klas Palin of Erik Penser Bank. Klas, please go ahead. Your line is open.
Thank you so much. Thanks for taking my questions. I would like to start with a question if you could share your thoughts about how well the new guidance has been spread and in the U.S. and if you see a positive impact of the new guidance in Europe as well at the moment.
I think we see the most, the most significant impact we can see in the U.S. We see it in a way that there is an significant increase in demand for evaluation and the product.
Okay. When you say you see a great interest in evaluation, I mean, is it possible to, I mean, describe, how many, the kind of process that you're in right now?
I don't have the exact numbers, but there are evaluations that have recently been finished. There are evaluations that are currently ongoing, and there are the evaluations that are planned in the coming weeks. It's a lot.
Do you feel this is a growing number, going forward into the year?
Yes.
Okay.
Yes.
Perfect. Perfect.
Growing number.
Perfect. I'm a little bit curious also about your repeat business that seems to take off with the sensor sales. If it is possible to describe how much of your sales in Q1 that is related to this repeat business or from the install base compared to when you ship to new customers. Is it possible to give some sort of an indication?
The results are mainly driven by the increased utilization rate. It's also closely followed by new customers.
Okay. sounds good. You describe a little bit the improvement in the utilization rate. How do you work with hospitals to improve this further?
We recently did a change specifically in the business where we now have separated the commercial team in two. We have the more sales-focused people. They are actually working to really close the deals. Then we have the more clinical salespeople, and they are nationally based, and they support the evaluation before the deal is closed, and then the activation after the closing of the deal and the shipment. This is a much faster process, and we can also deploy our resources in a more efficient way.
Okay. Perfect. Have you had any sales of ExSpiron during the first quarter, or is it mainly TetraGraph?
We have continuous sales of ExSpiron and PadSet, but the majority is TetraGraph.
If you look at the cost side in Q1, is that what we should how we should see the future as well from your side in the coming quarters?
We still have some one-offs in Q1, so we believe that the burn rate will go down, will continue to go down.
Great. Thank you so much. Congratulations for a very good quarter.
Very well. Thank you.
Thank you. We have a few questions sent by email. Question one, congratulations on the strong Q1 report. Sales growth, especially for the sensors, was great. Should we expect to continue to see growth at the same level going forward? Thank you.
I would expect to see continued growth in every quarter. Yeah, we are at the beginning. I didn't hear the full question. Was that an answer to the question?
Sorry. The full question was congratulations on the strong Q1 report. Sales growth, especially for the sensors, was great. Should we expect to continue to see growth at the same level going forward?
Yeah.
Brilliant. Thank you. The next question, what are the main drivers of sales in the quarter? Thank you.
The main drivers are really, as I said before, it's the increased utilization rate, but also new customers. We also see that the pediatric sensor is adding momentum to us. We have a very good competitive advantage here.
Thank you. The next question, can you please elaborate a bit more about the pediatric sensors? Thank you.
The pediatric sensor is very unique for us and we have the only FDA-approved pediatric sensor and also well designed to suit this group. It's also, without being too technical, the electromyography, which is an other type of objective monitoring, does not work for children because they have small fingers. We have a very unique competitive advantage in just children.
Thank you. The next question, do you think that you have an organization in the U.S. that is large enough to really capture the opportunities you have? Thank you.
For the current stage we are in, I think we are, we have a good organization. With the focus and the strategy we have, we had for a moment.
Thank you. The next question, you say in the report that the increased utilization rate is a main driver of top line. I guess that the rate will fluctuate depending on how many monitors you have installed in the quarter. Is there a good way to track the number of installations? Thank you.
Okay. Yes, I think I would, we can see now a stable utilization of the sensors. Of course, when a deal is being closed, a big new hospital is being closed or not, that doesn't have a great impact on the quarter. That's for sure. Otherwise, I think we are putting the details that we communicate in the report.
Thank you. The next question, you recently raised capital. Given your quarterly burn rate, it seems as if you need to raise additional capital again soon. How long will the capital last? Thank you.
We believe that the capital will take us through into the beginning of 2024.
It appears we have no further questions. I will now hand back to Pia for any closing comments.
Okay. No, thank you very much. Thank you for listening in and, of course, we are very excited about this, where we are today and the momentum we have. Thank you for joining in.