Correspondence (reply): In Reply

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.