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Investor Presentation April 2025 Making Aquadex the Standard of Care for
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3 Our Mission Nuwellis is dedicated to transforming the lives of patients
suffering from Fluid Overload through science, collaboration, and innovation.
Nuwellis is at a Strategic Inflection Point 1: Pinney, S et. al., J AM Coll
Cardiol HF, 2025, ISSN 2213-1779 https://doi.org/10.1016/j.jchf.2024.11.018 Critical Care + Pediatrics Expanding Outpatient Care Bridging Specialties in Care Delivery Now ~80% of our business, reflecting strong demand. Prioritized based
on strong clinical outcomes and patient needs. Motivated by a 4x increase in reimbursement rates, enhancing the economic feasibility of outpatient treatments. Aims to reduce long-term healthcare costs and improve outcomes through
preventative care. Strengthening integration between cardiology and nephrology to advance fluid management. Backed by the JACC1 study findings, which highlight the efficacy of early intervention in fluid overload conditions.
Significant Growth in Critical Care and Pediatrics Drives Strategic Focus 2:
Internal Sales Data As critical care and pediatrics now constitute ~80% of our sales, Nuwellis is realigning its resources towards the Critical Care and Pediatrics customer categories to capitalize on their growth.
Hospitals can now obtain up to $1,639 per day for Aquadex in outpatient care,
improving accessibility and financial viability. 4x Higher Reimbursement APC 5241 APC 5242 Introducing New Outpatient Reimbursement Rate for Aquadex With the reassignment of CPT 0692T, daily reimbursement rates have significantly
increased, making Aquadex a sustainable option for hospitals to provide essential outpatient care without financial loss.
Financial Incentive for Hospitals to Use Aquadex in Outpatient Setting Our
outpatient customer category boasts a strong pipeline, indicating significant, near-term revenue opportunities. 3: From Premier Applied Sciences database Increased Reimbursement With reimbursements now up to $1,639, outpatient Aquadex
treatments cover operational costs. Cost Avoidance Avoiding readmissions with proactive outpatient care can save hospitals up to $24,027 per readmission, reducing non-reimbursable expenses.3 Shifting to outpatient care with Aquadex
significantly enhances patient quality of life by reducing hospital readmissions and minimizing the risks associated with prolonged hospital stays. Recurring Revenue Not only improves patient outcomes but also ensures a steady revenue
stream from continuous care, rather than episodic inpatient treatments.
The Updated Reimbursement Opportunity is a Win-Win Across the Entire Healthcare
Ecosystem PATIENTS Gives easier access to improved, preventative care, enhancing overall quality of life. PAYOR Promotes cost efficiency, reducing expenses across the healthcare system. NUWELLIS Drives business growth and expands
market presence. HOSPITALS Financially Viable Therapy
Expanding Opportunities Across Critical Customer Categories 4: See
Appendix Heart Failure $1B Market4 Critical Care $900M Market4 Pediatrics $130M Market4 $2.53B+ TAM Outpatient Treatment $773M Market4 Leveraging growth in critical care, pediatrics, and outpatient settings to maximize market reach
We Are Progressing Toward Key Milestones In The REVERSE-HF
Trial 2022 2023 2024 2025 2026 2027 First Patient 100th Patient February 150th Patient Q3 Enrollment Completion Q1 Study Completion Insights from the REVERSE-HF Trial will support outpatient and critical care strategies by
validating the effectiveness of Aquadex therapy in reducing heart failure events. Primary Goal: Compare the effectiveness of Aquadex therapy versus IV loop diuretics in preventing heart failure events within 30 days
post-treatment. ANTICIPATED IMPACT Improving Care Standards: Potential to influence guidelines and enhance both outpatient and critical care strategies. Validation for Outpatient Care: Data could bolster the case for broader outpatient use
by demonstrating safety and effectiveness.
Our Strategic Growth Plan Emphasizes Four Key Efforts 1 2 3 4 We've
structured our sales and marketing team to ensure seamless execution
Strategic Focus on Critical Care for 2025 Strategically optimizing the patient
journey with targeted fluid management solutions that enhance outcomes at every stage. Pre-Op Optimization Post-Op Recovery Alternative to Conventional Methods Optimizes pre-surgery fluid levels, reducing intraoperative risks and setting
the stage for successful outcomes. Rapidly corrects post-surgical fluid imbalances, expediting recovery and reducing the length of hospital stays. Provides more controlled fluid removal than diuretics, enhancing recovery and minimizing side
effects. By reducing fluid overload, Aquadex speeds up recovery and decreases both heart-lung machine dependence and ICU stays.5 5: Beckles Journal of Cardiac Surgery - 2022 - Beckles - The use of simple ultrafiltration technology as a
fluid management strategy
There is a critical and widespread incidence of acute kidney injury among
cardiac surgery patients As many as 80% of cardiac surgery patients may have stage 1 or greater CSA-AKI according to the strict, consensus-based guidelines published by the Kidney Disease Improving Global Outcomes (KDIGO) group6. 6
Engelman, D. T., & Shaw, A. D. (2023). A Turnkey Order Set for Prevention of Cardiac Surgery-Associated Acute Kidney Injury. The Annals of Thoracic Surgery, 115(1), 11-15. https://doi.org/10.1016/j.athoracsur.2022.10.022 Recognizing the
critical link between fluid overload and acute kidney injury underscores the imperative for precise fluid management in cardiac surgery patients. 80% 20%
Our Solution Aquadex A clinically superior solution for Fluid Overload7 The
only device of its kind in the market 7: Pinney, S et. al., J AM Coll Cardiol HF, 2025, ISSN 2213-1779 https://doi.org/10.1016/j.jchf.2024.11.018
Filtered blood returns to the patient via the infusion line 5 Blood is taken
from the patient via the withdrawal line using proprietary catheter technology 1 The blood is pushed through the filter by the blood pump (0-40 ml per minute) 2 The ultrafiltration pump withdraws fluid across the filter membrane using
negative pressure Hematocrit sensor monitors preset hematocrit limits 3 Ultrafiltration pump can pull 0-500 ml of fluid per hour 4 How the Aquadex system works Predictable and precise fluid removal
Vivian Our pediatric solution
Received 510(k) and launched commercially in Q1 2020. Our Growth and Success in
Pediatrics Drive the Development of a Dedicated Device for High-Risk Conditions 8: Table Source: Menon S, et al. CJSN, 2019; 14: 1432-40. Aquadex is currently cleared for use in pediatric patients weighing 20 kg or more Attributes8 Group
1: <10kg Group 2: 10-20kg Group 3: >20kg # of Patients N = 72 N = 13 N = 34 Primary disease 43% kidney 29% cardiac 54% kidney 31%other 38% kidney 28% cardiac Survival at end of treatment (Aquadex) 43 (60%) 13
(100%) 33 (97%) Group 1 patients traditionally do not receive any kind of therapy "For our babies born with diseased or absent kidneys, Aquadex has given them a chance at life because in the past, there were no options to treat these
patients." Kara Short MSN, CRNP, NICU nurse practitioner at Alabama Children's Hospital 4-10 circuits/pts 3-6 consoles per hospital Improved patient survival at end of treatment
Reappraisal of AVOID-HF Published in JACC: HF in 2025 Demonstrated Aquadex
Significantly Reduces Heart Failure Hospitalizations9 Reassessed clinical benefit of ultrafiltration versus intravenous diuretics in 224 hospitalized heart failure patients. 9: Pinney, S et. al., J AM Coll Cardiol HF, 2025, ISSN 2213-1779
https://doi.org/10.1016/j.jchf.2024.11.018 Key Reappraisal Conclusions: Reanalysis confirmed a 60% decrease in 30-day HF events for patients treated with ultrafiltration9 Adjudicated an additional 31 events to complete the AVOID-HF
adjudicated dataset9 Study illustrates a clear trend toward a better overall composite outcome including CV mortality, HF events and quality of life9
We Are Confident That Our Growth Strategy Will Lead To Meaningful Revenue
Expansion And Improved Cash Flow Cash $5.1 million as of December 31, 2024 NO Debt Operating Expense 26% reduction vs. 2023
Capitalization Overview As of March 31, 2025 Common Equivalents Common
Stock 4,373,968 Preferred Stock 69,039 Warrants (weighted avg. exercise price: $5.49) 5,325,058 Options (weighted avg. exercise price: $524.67) 3,385 Fully Diluted 9,771,450
Nuwellis Leadership Team John Erb Interim Chief Executive Officer John
Jefferies, M.D. Chief Medical Officer Megan Cotts Vice President of Clinical Research and Reimbursement Rob Scott Chief Financial Officer Laurent Duhoux Vice President of International Business Development Over 200 years of combined
experience in clinical practice and the medical device industry, including major tenures at Medtronic, Boston Scientific, and Abbott/St. Jude Medical. Neil Ayotte Sr. Vice President, General Counsel, Chief Compliance Officer Ryan
Marthaler Vice President of Product Marketing and Business Development Betsy Riemenschneider Vice President of Sales
Investment Highlights Strategic Realignment Financial Growth Clinical
Advancement Focus on high-growth categories Expanded impact through strategic shifts to outpatient services Consistent upward trajectory in peds and critical care sectors. Leveraging improved reimbursement models Pediatric dedicated
device, Vivian REVERSE HF Trial Capitalizing on strategic shifts and proven clinical outcomes to drive substantial market presence and financial success, poised for dramatic growth in 2025.
Market size sources Heart Failure - Inpatient ($1B+) Incidence of HF:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494150/ Annual HF Hospitalizations: Costanzo MR, et al. J Am Coll Cardiol. 2017 May 16;69(19):2428-2445 Insufficient diuretic response:
https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.115.002370?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Heart Failure - Outpatient ($0.5B+) Incidence of HF:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494150/ Annual HF Hospitalizations: Costanzo MR, et al. J Am Coll Cardiol. 2017 May 16;69(19):2428-2445 Diuretic resistance rate:
($130m) Renal Replacement/AKI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789331/#:~:text=The%20hospitalized%20population%20at%20risk,are%20shown%20in%20Table%201 Heart Disease: