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Although many medications are used in Advanced life support, the only medication with proven efficacy in pediatric resuscitation is epinephrine. Despite numerous investigations, the optimal dose remains controversial.
Furthermore, some controversy exists in relation to first-line and second-line treatment regimens for fetal supraventricular tachycardia. In general, digoxin is used as first-line treatment in the US, whereas in Europe flecainide is used for this purpose. For second-line treatment of drug-refractory supraventricular tachycardia with hydrops fetalis, Parilla and colleagues advocate early use of fetal intramuscular digoxin.