Respiratory support and/or controlled mechanical ventilation of a patient are provided. A ventilation apparatus may include a ventilator, a transtracheal prosthesis, and a respiratory relief device. The transtracheal prostheses and ventilation catheter may be arranged such that the patient can breathe freely through the upper airway and/or the tracheal prostheses. Respiratory sensors may measure a breathing rate, lung pressure, airway pressure, or a combination thereof. Pulses of gas may be provided to the patient through the ventilation catheter during inspiration. The pulses may have a first volume while the patient breathes normal and a second volume when the sensors detect a cessation of breathing or reduction in breathing volume. The second volume may be provided at 1-5 times the normal breathing rate, with a volume 25-500% times the first volume, or both.
