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 redistributing inspired air to other healthier lung areas, for treating respiratory disorders such as COPD, ARDS, SARS, CF, and TB. 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. The catheter can be left in place for extended periods without clinician attendance or vigilance. Ventilation includes delivery of respiratory gases, therapuetic gases or agents and evacuation of stagnant gases, mixed gases or waste fluids. Typically the catheter's distal tip is anchored without occluding the bronchus but optionally may intermittently or continuously occlude the bronchus. TTSV is optionally performed by insufflation only of the area, or by 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.