A cardio pulmonary CPR device and method that provides enhanced circulation by an optimal combination and sequencing of maximal positive and maximal negative intrathoracic pressures, while maintaining a degree of passive ventilation to the patient. Namely, the embodiments of the invention provide for an optimal positive thoracic pressure compression state, with passively or actively filled lungs, achieved by either passive chest recoil with an open airway, or an active inflation mechanism. Said embodiments also provide for an optimal negative pressure decompression state, combined with actively emptied lungs (by chest compression).