Introduction Sudden cardiac arrest (SCA) remains a major health issue worldwide with gloomy outcomes due to poor perfusion of cardiopulmonary resuscitation (CPR), deemed unsuitable for hemostatic conditions, cardiotorsal anatomy, electrophysiology and thoracic biomechanics. Alternatively, we propose a new management, implementing rational mobilization of stagnant blood: manually with a novel technique of cardiac massage and mechanically with a circulatory flow restoration (CFR) device. Methods Simulated chest compressions were performed through the 5th intercostal space in professional Lifeguards volunteers, placed in the left lateral decubitus position with raised legs and abdominal compression. Expected results Compared to CPR, bypassing the sternal barrier, refilling the heart and then compressing the chest with a recoil-rebound maneuver (3R / CPR) can significantly promote ROSC. Results of CFR device were previously demonstrated. Conclusion 3R/CPR adapts human morphology promoting adequate perfusion and ROSC safely, under all circumstances. Preclinical computational models can confirm the effectiveness of 3R/CPR versus CPR.
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