Methods, systems and devices are described for new modes of ventilation in which specific lung areas are ventilated with an indwelling trans-tracheobronchial catheter for the purpose of improving ventilation and reducing hyperinflation in that specific lung area, and for redirecting inspired air to other healthier lung areas. Trans-tracheobronchial Segmental Ventilation (TTSV) is performed on either a naturally breathing or a mechanical ventilated, patient by placing a uniquely configured indwelling catheter into a bronchus of a poorly ventilated specific lung area and providing direct ventilation to that area. Typically the catheters distal tip is anchored without occluding the bronchus. TTSV is optionally performed by insufflation only of the area, or by the application of vacuum to the area, can include elevating or reducing the pressure in the targeted area to facilitate stagnant gas removal, or can include blocking the area to divert inspired gas to better functioning areas.
