An HME for a tracheostomy tube has a flexible outer housing of a gas-permeable material containing an HME element of discrete particles, granules or the like of a hygroscopic material. The particles are contained between the outer housing and an inner wall of a foam. The inner wall has a ciliated surface facing the end of the tube, which acts to distribute gas over the surface of the HME element. The HME is attached to a flange on an inner cannula by means of a removable adhesive. The HME may include a suction port through a self-closing aperture, which makes a wiping seal with a suction catheter inserted in the tube.