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Sustained Low Efficiency Dialysis (SLED) treatment – Mission Health Blog


“Let’s go sledding!” Mission Hospital Assistant Chief Nursing Officer Jackie Gosnell said with excitement as she and her colleagues walked toward the Medical Surgical ICU.

In the spring of 2022, Medical Surgical ICU RN Erin Smart treated her patient with the hospital’s very first Sustained Low Efficiency Dialysis (SLED) treatment.

“I’m excited to see how this works for our patients. It will be less time the patient has be hooked up to a machine so we can mobilize them a bit earlier,” Smart said.

This form of dialysis, which will be used in adult ICUs only, is all about quality of life for the patient.

“This is considered an ‘in between therapy,’ said Gosnell. “SLED isn’t 24/7, instead it’s 6-12 hours, once a day. In the past, when the patient wasn’t quite stable enough to go to hemodialysis for the 4-hour treatment, they had to stay on Continuous Renal Replacement Therapy (CRRT) because they weren’t quite ready for the transition.”

Echoing the excitement of the morning, RN and clinical educators Beth Carlson and Mary Lou Adams waited outside the patient’s room ready to assist with the first SLED treatment.

“It’s going to meet a need we have. We will be able to treat patients more efficiently,” said Carlson.

The SLED treatment was made possible through the purchase of 18 inclusive dialysis machines- eight of the machines are designated for SLED treatments at Mission Hospital and the remaining 10 are used for outpatient hemodialysis. The machines are small, compact and have a built-in water filtration system.

It took roughly a year for the SLED project to go-live, thanks to the collaborative efforts of hospital educators, IT, materials management, biomed and facilities team members.