In OxCaml, it has support for the effect system that we added in OCaml 5.0 onwards, which allows for a fiber to suspend itself and be restarted via a one-shot continuation. So it's possible to have a pipelined connection stash away a continuation for a response calculation and be woken up later on when it's ready.
All continuations have to be either discarded explicitly or resumed exactly once; this can lead to memory leaks in OCaml 5, but OxCaml has an emerging lifetime system that guarantees this is safe: https://oxcaml.org/documentation/parallelism/01-intro/ or https://gavinleroy.com/oxcaml-tutorial-icfp25/ for a taste of that. Beware though; it's cutting edge stuff and the interfaces are still emerging, but it's great fun if you don't mind some pretty hardcore ML typing ;-) When it all settles down it should be very ergonomic to use, but right now you do get some interesting type errors.