When someone experiences liver failure excessive fluid in the brain causes pressure that can move brain tissue and deprive it of oxygen. Additionally, it is no longer able to offer the clotting factors that prevent blood from being too thin, resulting in bleeding disorders. One of the first places where this occurs is the gastrointestinal tract. It also makes people vulnerable to infections, and places extra pressure on the kidneys that results in them beginning to fail.
As the kidneys are responsible for excreting waste and maintaining an electrolyte imbalance, the patient may enter metabolic acidosis. The kidneys are no longer able to remove ketones from the blood, making it more acidic. Low sodium bicarbonate and high lactic acid levels have the same effect. As a result, the patient may develop ketone breath, which has a fruity scent. He or she may also become fatigued, lethargic, confused and drowsy. Eventually, his or her heart may begin to suffer, including arrhythmias such as tachycardia, edema and congestive heart failure.