Preservation of the brain is the obvious goal of every cardiopulmonary resuscitation, but resumption of heart and lung function is the only chance to achieve that goal. In the field, basic life support without equipment remains the mainstem of resuscitation. But what should we do if we are not successful, if even advanced life support does not restart the heart? Should we give up or should we add to the advanced life support a new concept: extended cardiopulmonary resuscitation by mechanical support? This would allow more time for the heart to recover or to begin definitive therapy. Prolonged mechanical support could support weak function of the failing heart or lungs until they return to full performance.