An apparatus, system, and method for managing respiratory secretions and fluids in sections of artificial airways. In an embodiment of the invention, a respiratory secretion retention (RSR) device configured to fluidly connect to an artificial airway can be provided. The device can include a housing that defines a passageway for the flow of respiratory gases with at least two chambers coupled to the housing. The chambers are configured to retain exhaled respiratory particulate and liquid. The respiratory secretion retention device further includes a patient port coupled to the housing that is in fluid communication with the artificial airway and a repositionable barrier configured to isolate at least one of the two chambers from the passageway. In another embodiment, a secretion removal assembly can connect to a respiratory secretion retention device; the secretion removal assembly includes a connector configured for connecting to a port of the respiratory secretion retention device and a spike coupled to the connector.