LNSLNS

We thank our correspondents for their interest in our work and for their responses.

Our article presented a systematic review of studies available to date on long-term cognitive dysfunction after conservative intensive care treatment. It explains the prevalence, disease course, and the risk factors studied so far and pharmacological and non-pharmacological interventions, and discussed them on the basis of the available data (1).

We are grateful for the suggestion of possible pharmacotherapy using piracetam. The long-term sequelae of a critical illness (often months to years) that were the focus of our article are, however, not congruent with the (controversial) term “Durchgangssyndrom” (organic psychosis which is understood to last a few days) (2). The effects of treatment with piracetam have so far not been investigated in studies of the long-term sequelae of conservative intensive care treatment.

We thank our correspondent for mentioning possible pharmacological treatment using vitamin B1. Alcoholism and associated syndromes and disorders—such as Wernicke encephalopathy or Wernicke-Korsakov syndrome—play an important part in intensive care medicine (3, 4). Studies thus far have, however, not been able to establish any association with the long-term cognitive effects of intensive care treatment for the group of patients with thiamine deficiency or insufficient treatment with thiamine.

DOI: 10.3238/arztebl.2020.0116c

On behalf of the authors
Dr. med. Julius Valentin Emmrich, MPhil
Klinik für Neurologie
mit Abteilung für Experimentelle Neurologie
Charité – Universitätsmedizin Berlin
julius.emmrich@charite.de

Conflict of interest statement
The authors of all contributions declare that no conflict of interest exists.

1.
Kohler J, Borchers F, Endres M, Weiss B, Spies C, Emmrich, JV: Cognitive deficits following intensive care. Dtsch Arztebl Int 2019; 116: 627–34 VOLLTEXT
2.
Ewert T: Postoperatives Durchgangssyndrom. Dtsch Arztebl 1986; 83: A-956 VOLLTEXT
3.
Singer MV, Teyssen S: Serie – Alkoholismus: Alkoholassoziierte Organschäden. Dtsch Arztebl 2001; 98: A-2109 VOLLTEXT
4.
Maschke M, Kommission Leitlinien der Deutschen Gesellschaft für Neurologie: S1-Leitlinie Alkoholdelir und Verwirrtheitszustände. 2015. AWMF-Registernummer: 030/006 .
1.Kohler J, Borchers F, Endres M, Weiss B, Spies C, Emmrich, JV: Cognitive deficits following intensive care. Dtsch Arztebl Int 2019; 116: 627–34 VOLLTEXT
2.Ewert T: Postoperatives Durchgangssyndrom. Dtsch Arztebl 1986; 83: A-956 VOLLTEXT
3.Singer MV, Teyssen S: Serie – Alkoholismus: Alkoholassoziierte Organschäden. Dtsch Arztebl 2001; 98: A-2109 VOLLTEXT
4.Maschke M, Kommission Leitlinien der Deutschen Gesellschaft für Neurologie: S1-Leitlinie Alkoholdelir und Verwirrtheitszustände. 2015. AWMF-Registernummer: 030/006 .

Info

Specialities