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Table 2 Advantages and disadvantages of heat and moisture exchanger filter and heated humidifier systems during non-invasive ventilation

From: Clinical review: Humidifiers during non-invasive ventilation - key topics and practical implications

System Advantages Disadvantages
HME Cost effective Increased dead space
  Extended use in the ICU Reduced efficacy in case of leaks
  Eliminates circuit condensation (hygroscopic models are recommended) Efficacy depends on body and environmental temperatures
  A booster system applied to a hydrophobic HME may preserve AH capacity when incoming gases are delivered at a temperature lower than 26°C and at high flow May lead to an increase in airway resistance in patients with heavy secretions and respiratory tract bleeding
  Does not need electricity  
HH Less work of breathing than with HME Less efficacy with high environmental temperature
  Limited or no effect on dead space ventilation so CO2 retention is minimal Needs electricity
  Achieves RH and AH values sufficient for gas conditioning Performance of different devices varies
  Clinically effective, especially in patients with mild to severe hypercapnic acute respiratory failure  
  1. AH, absolute humidity; HH, heated humidifier; HME, heat and moisture exchanger filter; RH, relative humidity.