The Use of Peripheral Parenteral Nutrition in Hospitalized Patients: A Clinical Case Series

Introduction: Patients with dementia, severe gastrointestinal disorders, or anorexia nervosa are at increased risk of malnutrition and frequently require hospitalization. Nutritional management may be complicated by intolerance or refusal of enteral nutrition (EN), contraindications to EN or central parenteral nutrition (CPN), and delays in long-term strategies such as percutaneous endoscopic gastrostomy (PEG). The existing literature provides limited practical guidance for addressing these challenges in internal medicine settings. This retrospective case series describes three hospitalized adults who required prompt medical nutritional support and were managed with peripheral parenteral nutrition (PPN): one patient with dementia and acute pneumonia, one adult with anorexia nervosa unsuitable for EN, and one patient with severe acute pancreatitis. Given the scarce indications from the literature for managing these situations, the objective of this case series was to illustrate the clinical decision-making involved in these three cases rather than to demonstrate the efficacy of the PPN strategy. Cases were selected using predefined criteria to highlight therapeutic reasoning across heterogeneous conditions. Results: The duration of PPN administration ranged from 7 to 10 days. An initial improvement in key nutritional parameters from the first day of PPN initiation was observed after 7 days in the patient with dementia, after 1 month in the patient with anorexia nervosa, and after 8 days in the patient with severe acute pancreatitis. Overall clinical conditions improved concurrently. Conclusions: In these clinical contexts, PPN appeared to offer a short-term, feasible option for initiating nutritional support or serving as a temporary bridge while planning more definitive strategies, although this remains a hypothesis that requires confirmation in larger studies.