Mechanical measures intended to increase blood flow to vital organs are the mainstay of therapy for patients in cardiac arrest. Several new cardiopulmonary resuscitation techniques and devices have been developed and tested since the first report of manual closed-chested cardiopulmonary resuscitation nearly four decades ago. These include vest cardiopulmonary resuscitation, active compression-decompression cardiopulmonary resuscitation, an intra-aortic perfusion balloon pump, and an inspiratory impedance threshold valve, interposed abdominal counterpulsation cardiopulmonary resuscitation, and phased thoracic-abdominal compression and decompression. Many of these new mechanical advances in the treatment of cardiac arrest are currently undergoing clinical evaluation in patients in cardiac arrest. Although some of these new methods and techniques have shown promise in small human clinical trials, none have yet to be found to be conclusively superior to manual closed-chested cardiopulmonary resuscitation.