Fecal Microbiota Transplantation
Fecal Microbiota Transplantation
Donor stool preparation is done using standard precautions. Usually, donor stool is instilled within 6 hours of the donor's bowel movement. First it's diluted using preservative-free sterile saline solution. Next, a fecal slurry is made by manually stirring it or using a blender until the stool is of a consistency that allows for aspiration. The fecal slurry is filtered using gauze or a mesh strainer to remove as much particulate as possible, and is instilled immediately.
Several methods can be used to deposit the slurry—colonoscopy, retention enema, or nasogastric (NG) tube. No established guidelines exist for the best instillation method or amount of slurry to instill; clinicians should consider the patient's size and instillation method. For an average-size adult, 50 to 200 mL are instilled via NGT; for colonoscopic instillation, 250 mL to 500 mL are instilled.
If the patient is receiving the slurry through an NG tube, additional nursing considerations apply. Once the physician prepares and filters the stool, the nurse draws up the slurry into a clean 60-mL syringe and injects the prescribed amount slowly (50 mL over 2 to 3 minutes) into the NG tube, followed by a 50-mL flush of saline solution.
Procedure
Donor stool preparation is done using standard precautions. Usually, donor stool is instilled within 6 hours of the donor's bowel movement. First it's diluted using preservative-free sterile saline solution. Next, a fecal slurry is made by manually stirring it or using a blender until the stool is of a consistency that allows for aspiration. The fecal slurry is filtered using gauze or a mesh strainer to remove as much particulate as possible, and is instilled immediately.
Several methods can be used to deposit the slurry—colonoscopy, retention enema, or nasogastric (NG) tube. No established guidelines exist for the best instillation method or amount of slurry to instill; clinicians should consider the patient's size and instillation method. For an average-size adult, 50 to 200 mL are instilled via NGT; for colonoscopic instillation, 250 mL to 500 mL are instilled.
If the patient is receiving the slurry through an NG tube, additional nursing considerations apply. Once the physician prepares and filters the stool, the nurse draws up the slurry into a clean 60-mL syringe and injects the prescribed amount slowly (50 mL over 2 to 3 minutes) into the NG tube, followed by a 50-mL flush of saline solution.
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